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Transmission: Plague is usually transmitted to humans by the bites of infected rodent fleas. During rodent plague outbreaks, many animals die and their hungry fleas seek other sources of blood to survive. Persons and animals that visit places where rodents have recently died from plague risk getting the disease from flea bites. Persons also can become directly infected through handling infected rodents, rabbits, or wild carnivores that prey on these animals, when plague bacteria enter through breaks in the person's skin. House cats also are susceptible to plague. Infected cats become sick and may directly transmit plague to persons who handle or care for them. Also, dogs and cats may bring plague-infected fleas into the home. Inhaling droplets expelled by the coughing of a plague-infected person or animal (especially house cats) can result in plague of the lungs (plague pneumonia). Transmission of plague pneumonia from person to person is uncommon but sometimes results in dangerous epidemics that can quickly spread.  Distribution: Wild
rodents in certain areas around the world are infected with plague. Outbreaks
in people still occur in rural communities or in cities. They are usually
associated with infected rats and rat fleas that live in the home. In the
United States, the last urban plague epidemic occurred in Los Angeles in
1924-25. Since then, human plague in the United States has occurred as mostly
scattered cases in rural areas (an average of 10 to 15 persons each year).
Globally, the World Health Organization reports 1,000 to 3,000 cases of
plague every year. In North America, plague is found in certain animals
and their fleas from the Pacific Coast to the Great Plains, and from southwestern
Canada to Mexico. Most human cases in the United States occur in two regions:
1) northern New Mexico, northern Arizona, and southern Colorado; and 2)
California, southern Oregon, and far western Nevada. Plague also exists
in Africa, Asia, and South America (see maps above).
References: Gage KL. Plague. In: Colliers L, Balows A, Sussman M, Hausles WJ, eds. Topley and Wilson’s microbiology and microbiological infections, vol 3. London: Edward Arnold Press, 1998:885-903. Centers for Disease Control and Prevention. Prevention of plague. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 1996;45(RR-14):1-15. Poland JD, Barnes AM. Plague. In Steele J (ed): Handbook of Zoonoses. Boca Raton, FL:CRC Press, 1979:515-559. Barnes AM. Surveillance
and control of bubonic plague in the United States. Symp Zool Soc Lond,
1982;50:237-270. |
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