Plague, caused by the bacterium Yersinia pestis, spreads mainly through the bite of an infected rodent flea or by handling infected animals. In the western United States it is rare but potentially life-threatening, takes bubonic, septicemic or pneumonic forms, mostly affects rural people, and is treatable with antibiotics if caught early. It is most often identified from May to August — which made this case unusual.
What happened
| 2024 | |
|---|---|
| January 19 | a 2-year-old cat in Central Oregon starts veterinary care for a neck abscess and vomiting; it's given an oral antibiotic |
| January 24 | a veterinarian removes and drains the abscess |
| January 25 | the cat's owner, a 73-year-old man, cuts his right index finger with a kitchen knife; it's cleaned and stitched at urgent care. That day he has close contact with the cat |
| January 26 | a new, tender, raised ulcer appears on his right wrist |
| January 30 | he goes to an emergency department with cellulitis and swollen, inflamed lymph channels and nodes running up to his armpit; he's admitted and started on intravenous ceftriaxone and metronidazole |
| January 31 | the cat dies — its owner hadn't been able to give it its antibiotics after surgery |
| February 6 | Y. pestis, grown from his blood, is confirmed by PCR and bacteriophage testing at the Washington State Public Health Laboratory, standing in for Oregon's lab during renovations |
| February 7 | switched to intravenous gentamicin and levofloxacin, he improves and goes home with a 9-day course of oral levofloxacin |
| February 15 | he appears fully recovered, apart from mild fatigue |
He had no direct contact with rodents. CDC's laboratory in Fort Collins, Colorado, later confirmed Y. pestis in tissue from the cat's liver and spleen.
Why it matters
- A record early case. His January 30 visit is the earliest calendar date for plague in Oregon's records — earlier in the year than any of the state's 18 other human cases in the previous 90 years — perhaps a sign that plague's season is shifting.
- Fleas in winter. Vectorborne diseases can emerge or return as climate, soils, forest cover and land use change. The mild climates of California's Central Valley and the Pacific Northwest can let fleas emerge year-round, and unseasonably warm winters can extend their life cycle. Flea eggs can hatch at temperatures as low as 50°F (10°C) — close to Central Oregon's average when the cat fell ill. How climate affects plague is still being studied.
- Cats can pass it on. People can catch plague from sick pets, especially cats. Regularly treating pets and their surroundings for fleas may cut the risk.
- A missed chance. Plague wasn't considered when the cat was examined. Had it been, the owner could have been warned about catching it.
For vets and clinicians: where plague is established in wildlife, suspect Y. pestis in any feverish illness linked to animal contact — in any season. Public health messages and testing for plague are warranted year-round in these areas.
Sources
Based on DeBess E, Coyle K, Fawcett R, Hamade AK, Cieslak PR, "Notes from the Field: Early-Season Human Plague Transmitted from an Infected Cat — Oregon, January 2024," MMWR volume 74, number 26, Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
1
0
0
0
Comments
