One person has been infected with bubonic plague in Pueblo County, Colorado, about 100 miles south of Denver, local health officials announced Monday.
State and local officials identified the case last week based on preliminary test results. Tristen Garcia, a spokesperson for the Pueblo Department of Public Health and Environment, said in an email Tuesday morning that it is bubonic plague. An earlier announcement had referred to it as the more general “plague.” The infection was first reported on Friday. The department said the man was hospitalized with bubonic plague but his condition has improved. Because plague is endemic locally, Garcia said it’s difficult to pinpoint the source of infection.
Bubonic plague, which caused historic pandemics in Europe and Asia, is caused by the Yersinia pestis bacteria. The bacteria is transmitted by fleas carried by wild rodents such as rats and prairie dogs. Plague can be contracted when an infected flea bites a person, or when a person touches or scratches the skin of an infected animal.
Most plague cases in the United States occur in the Southwest (northern New Mexico, northern Arizona, and southern Colorado) and the West (California, southern Oregon, and western Nevada). According to the Centers for Disease Control and Prevention (CDC), an average of seven cases of plague occur in the United States each year.
A New Mexico man died of the plague in March, state health officials said. Authorities in Oregon confirmed a human case of plague in February. The Oregon case appears to have been traced to an infected pet cat.
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What are the symptoms of bubonic plague?
According to the World Health Organization, symptoms can develop after an incubation period of one day to one week, and the plague typically causes sudden fever and chills, severe headache, muscle pain, nausea and vomiting.
Common symptoms are swollen, painful lymph nodes, which is where the most common form of the disease gets its name: bubonic plague. These appear on the body as swelling in the armpits, groin, or neck, according to the Mayo Clinic. Bubonic plague lesions vary in size from less than half an inch to about four inches. Bubonic plague is not transmitted from person to person, the CDC said.
Other forms of plague include pneumonic plague, which occurs when bacteria infect the lungs, and septicemic plague, which occurs when bacteria infect the blood. Pneumonic plague is spread by inhaling droplets from an infected person. These droplets remain in the air for an hour after an infected person coughs. Pneumonic plague can also occur if untreated bubonic or septicemic plague bacteria spread to the lungs. Septicemic plague does not spread from person to person.
The WHO estimates that between 30% and 60% of people die from bubonic plague. Pneumonic plague is fatal if left untreated.
According to the CDC, there is no vaccine for plague in the United States. Anyone who develops symptoms of plague should seek medical help immediately. Antibiotics can treat plague, but prompt medical help is needed to avoid severe illness or death, Alicia Solis, infectious disease and emergency preparedness program manager for the Pueblo County Public Health Department, said in a statement.
How can I avoid this?
Wild rodents in the American West often carry the plague. With that in mind, Pueblo County health officials warned people to clear out areas near homes, garages, sheds and recreational areas where rodents may hide or breed. People should not allow pets to hunt or roam in rodent habitats, including prairie dog colonies, and dogs and cats should be treated for fleas regularly. Officials cautioned that flea collars have not been proven effective against plague-infected fleas. Officials also warned against letting pets sleep together.
You should also avoid contact with dead animals. If you must handle a sick or dead animal, use an insect repellent that contains 20 to 30 percent DEET for flea control, officials say. Use a long-handled shovel to pick up the animal and place it in a trash bag outside.
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‘Black Death’
Plague has been identified on every continent except Oceania, but the most endemic countries are the Democratic Republic of the Congo, Madagascar, and Peru. Historically, the disease has devastated the world’s population. In the 14th century, bubonic plague caused the Black Death pandemic, which killed an estimated 50 million people according to the WHO. More than a quarter of Europe’s population died, although some estimates are higher. Subsequent epidemics also occurred in China and India.
Past outbreaks in the United States and misunderstandings
The United States experienced plague epidemics for decades, but did not kill as many people there as elsewhere. In 1900, rat-infested ships from infected areas brought the plague, sparking epidemics in port cities such as San Francisco, where racist public health policies falsely blamed the Chinese community for bringing the disease and for being particularly susceptible, journalist David K. Randall wrote in “The Black Death at the Golden Gate.” In the mid-1920s, Los Angeles experienced the largest urban epidemic in the country, killing more than 30 people. At the time, in Southern California, public health officials blamed the “Mexican District,” just east of downtown.
However, the cause was fleas infected with the plague virus that lived on urban rodents, which then transmitted the virus to rodents in the rural West, creating a breeding ground for infection that continues to this day.
