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Plague
Fact Sheet
CLINICAL FEATURES
- Bubonic plague:
enlarged, tender lymph nodes, fever, chills and prostration
- Septicemic plague:
fever, chills, prostration, abdominal pain, shock and bleeding into
skin and other organs
- Pneumonic plague:
fever, chills, cough and difficulty breathing; rapid shock and death
if not treated early
ETIOLOGIC AGENT
- Yersinia pestis
- bacillus
INCIDENCE
- In the U.S., 1
to 40 cases reported annually (avg = 13 cases) by western states, 1971-1995
- Worldwide, 2861
cases reported by 10 countries to WHO in 1995
SEQUELAE
- Rare, consequences
of disseminated intravascular coagulation, lung damage
- Mortality 50-90%
if untreated; 15% when diagnosed and treated
COSTS
TRANSMISSION
- Flea-borne, from
infected rodents to humans
- Direct contact
with infected tissues or fluids from handling sick or dead animals
- Respiratory droplets
from cats and humans with pneumonic plague
RESERVOIRS
- Primarily wild
rodents in U.S. (especially rock squirrels, ground squirrels, prairie
dogs, other burrowing rodents)
- Commensal rats
may be important elsewhere
RISK GROUPS
- In the U.S., persons
exposed to rodent fleas, wild rodents, or other susceptible animals
in enzootic areas of western states
- Most cases occur
in southwestern states of NM, AZ, CO, and in CA
- Highest rates in
Native Americans, especially Navajos; other risk groups: hunters; veterinarians
and pet owners handling infected cats; campers or hikers entering areas
with outbreaks of animal plague
SURVEILLANCE
- National Notifiable
Disease Surveillance System (NNDSS) for animal plague surveillance,
for reports of human cases, and laboratory testing of fleas, animal
tissues and serum specimens, and serosurveys of carnivores
- CDC, Fort Collins,
is a WHO Collaborating Center for Reference and Research on Plague Control,
and reports all human plague cases in the U.S. to WHO
OPPORTUNITIES
- Increased self-sufficiency
of state and county public health labs
- Expanded active
surveillance through carnivore serosurveys and application of geographic
information systems (GIS) to surveillance programs
- Increased education
of public and health professionals
- Collaborative applied
research on plague prevention and control with other federal, state,
and local health agencies, including application of GIS to surveillance
RESEARCH
- Ecology-based
prevention and control strategies
- Improved diagnostic
reagents and methods
- Risk factor identification
using landscape ecology and epidemiology
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