Plague Kills Child in LaPlata County Colorado, Bacteria that Causes Plague Detected in 6 Counties in Colorado

The Colorado Department of Public Health and Environment (CDPHE) laboratory confirmed reports of plague in animals and fleas from six counties in Colorado: LaPlata County, San Miguel County, El Paso County, Boulder County, Huerfano County and Adams County.

One of the six counties with confirmed plague, LaPlata County, is where a 10-year-old resident died from causes associated with plague. Laboratory testing has since confirmed the presence of plague in a sample of fleas collected in the LaPlata County, according to CDPHE.

The plague is transmitted by blood infection and infection caused by inhalation. If detected early, plague is treatable in both people and pets. Symptoms include the sudden onset of high fever and/or swollen lymph nodes, according to CDPHE.

“In Colorado, we expect to have fleas test positive for plague during the summer months. Awareness and precautions can help prevent the disease in people. While it’s rare for people to contract plague, we want to make sure everyone knows the symptoms.The disease is treatable if caught early. Let a medical provider know if you think you have symptoms of plague or if you think you’ve been exposed.”

— Jennifer House, Deputy State Epidemiologist and Public Health Veterinarian for CDPHE

CDPHE reports that plague is caused by bacteria that can be transmitted to humans by the bites of infected fleas or by direct contact with infected animals. According to the Centers for Disease Control (CDC), blood contamination can occur from skinning animals, such as rabbits or from the bites of fleas. Blood contamination results in septicemia or bubonic plague. Inhalation contamination occurs from inhalation of infectious droplets and results in pneumonic plague. The bacteria that cause plague, Yersinia pestis, maintain their existence in a cycle involving rodents and their fleas. Plague occurs in rural and semi-rural areas of the western United States, primarily in semi-arid upland forests and grasslands where many types of rodent species can be involved. Many types of animals, such as rock squirrels, wood rats, ground squirrels, prairie dogs, chipmunks, mice, voles, and rabbits can be affected by plague. Wild carnivores can become infected by eating other infected animals.

Bubonic plague: Patients develop sudden onset of fever, headache, chills, and weakness and one or more swollen, tender and painful lymph nodes (called buboes). This form usually results from the bite of an infected flea. The bacteria multiply in the lymph node closest to where the bacteria entered the human body. If the patient is not treated with the appropriate antibiotics, the bacteria can spread to other parts of the body.

Septicemic plague: Patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. Septicemic plague can occur as the first symptom of plague, or may develop from untreated bubonic plague. This form results from bites of infected fleas or from handling an infected animal.

Pneumonic plague: Patients develop fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs. The pneumonia may cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only form of plague that can be spread from person to person (by infectious droplets).

Prevention

Reduce rodent habitat around your home, work place, and recreational areas. Remove brush, rock piles, junk, cluttered firewood, and possible rodent food supplies, such as pet and wild animal food. Make your home and outbuildings rodent-proof.

Wear gloves if you are handling or skinning potentially infected animals to prevent contact between your skin and the plague bacteria. Contact your local health department if you have questions about disposal of dead animals.

Use repellent if you think you could be exposed to rodent fleas during activities such as camping, hiking, or working outdoors. Products containing DEET can be applied to the skin as well as clothing and products containing permethrin can be applied to clothing (always follow instructions on the label). Otherwise, stay out of areas where wild rodents live.

In risky outdoor areas, tuck your pant cuffs into your socks to prevent flea bites.

Avoid all contact with wild rodents, including squirrels. Do not feed or handle wild animals. Do not touch sick or dead animals.

Keep fleas off of your pets by applying veterinary approved flea control products. Animals that roam freely are more likely to come in contact with plague infected animals or fleas and could bring them into homes. If your pet becomes sick, seek care from a veterinarian as soon as possible.

Use a leash and keep pets out of wild rodent habitats.

Do not allow dogs or cats that roam free in endemic areas to sleep on your bed.

Contact a veterinarian if your pet becomes sick with a high fever and/or an abscess (i.e. open sore) or swollen lymph nodes. Pets with plague can transmit the illness to humans.

Prevent rodent infestations around your house by clearing plants and materials away from outside walls, reducing access to food items. Consider setting traps or seek a professional animal trapper if DIY animal trapping is legal or if you don’t know the laws.

Consult with a professional pest control company to treat the area around your home for fleas.

Adults should keep children aware of these precautions and should be instructed to tell an adult if they have had contact with a wild animal or were bitten by fleas.

Note: A plague vaccine is no longer available in the United States. New plague vaccines are in development but are not expected to be commercially available in the immediate future.

The Illinois Department of Public Health includes information on plague. Plague has been reported previously in Chicagoland in Illinois, but the case was laboratory related. Initially, the University of Chicago Medical Center reported in 2009 that an infection that killed 60-year-old molecular genetics Professor Malcolm J. Casadaban on September 13, 2009 may have been connected to weakened strain of the bacteria Yersinia pestis that he researched.

According to a CDC report on the incident, the strain that killed Casadaban, known as KIM D27, had never been known to infect laboratory workers. The strain was known as an “attenuated” or weakened strain that had defective genes for iron uptake. On autopsy, Casadaban was found to have undiagnosed hereditary hemochromatosis (iron overload), which likely played a role in his death. The autopsy also involved immunohistochemical tests using an anti–Y. pestis mouse monoclonal antibody revealed abundant staining of Y. pestis in blood vessels of multiple organs that is consistent with septicemic plague. Close contacts of Casadaban were given prophylactic treatment. Also the research strain Casadaban was studying was studied to determine whether there were new virulence mechanisms acquired by or engineered into the strain that infected Casadaban. No increased virulence mechanism were discovered.

See also …

Fatal Laboratory-Acquired Infection with an Attenuated Yersinia pestis Strain — Chicago, Illinois, 2009

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