WEDNESDAY, June 13 (HealthDay News) — Although the plague is typically considered a remnant of the Middle Ages, when unsanitary conditions and rodent infestations prevailed amid the squalor of poverty, this rare but deadly disease appears to be spreading through wealthier communities in New Mexico, researchers report.
Why the plague is popping up in affluent neighborhoods isn’t completely clear, the experts added.
“Where human plague cases occur is linked to where people live and how people interact with their environment,” noted lead researcher Anna Schotthoefer, from the Marshfield Clinic Research Foundation in Wisconsin. “These factors may change over time, necessitating periodic reassessments of the factors that put people at risk.”
This latest study confirms previous reports that living within or close to the natural environments that support plague is a risk factor for human plague, Schotthoefer said.
Plague is caused by a fast-moving bacteria, known as Yersinia pestis, that is spread through flea bites (bubonic plague) or through the air (pneumonic plague).
The new report comes on the heels of the hospitalization on June 8 of an Oregon man in his 50s with what experts suspect is plague. According to The Oregonian, the man got sick a few days after being bitten as he tried to get a mouse away from a stray cat. The cat died days later, the paper said, and the man remains in critical condition.
For the new study, published in the July issue of Emerging Infectious Diseases, the researchers used U.S. Census Bureau data to pinpoint the location and socioeconomic status of plague patients.
About 11 cases of plague a year have occurred in the United States since 1976, with most cases found in New Mexico. Plague has also been reported in a handful of other states.
Although many cases were in areas where the habitat supports rodents and fleas, the researchers also found cases occurring in more upper-class neighborhoods. In the 1980s, most cases occurred where housing conditions were poor, but more recently cases have been reported in affluent areas of Santa Fe and Albuquerque, the investigators found.
“The shift from poorer to more affluent regions of New Mexico was a surprise, and suggests that homeowners in these newly developed areas should be educated about the risks of plague,” Schotthoefer said.
Schotthoefer noted that these more affluent areas where plague occurred were regions where new housing developments had been built in habitats that support the wild reservoirs of plague, which include ground squirrels and woodrats.
Bubonic plague starts with painful swellings (buboes) of the lymph nodes, which appear in the armpits, legs, neck or groin. Buboes are at first a red color, then they turn a dark purple color, or black. Pneumonic plague starts by infecting the lungs. Other symptoms include a very high fever, delirium, vomiting, muscle pains, bleeding in the lungs and disorientation.
In the 14th century, a plague called the Black Death killed an estimated 30 percent to 60 percent of the European population. Victims died quickly, within days after being infected.
Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said he doesn’t expect to see that kind of outbreak ever again.
“This is not a disease of the past, but you are never going to see a massive outbreak of plague in this country,” he said.
“We don’t have the public health problems we used to have and people would be quickly confined if there were ever a large number of cases,” Siegel explained.
Yet, it is not surprising to see plague in these more affluent areas, he noted.
“We know that plague only exists where you have wild animals, and once a reservoir of plague is already present it is likely to persist,” Siegel explained. “It isn’t only about squalor; it’s about where the reservoir is.”
However, if the disease is caught early it is treatable with antibiotics, Siegel added.
More information
For more information on plague, visit the U.S. National Library of Medicine.
Black Death backtrack: Don’t blame the rats, the plague was ‘spread by PEOPLE’
By Claire Bates and Luke Salkeld
For centuries rats have been blamed for spreading the Black Death, helping to consign millions of people to an agonising death.
But, according to one archaeologist, the rodents are innocent. Instead, the blame for passing on the disease that wiped out a third of the population of Europe could lie with the victims themselves.
The Black Death is widely thought to have been an outbreak of bubonic plague caused by bacteria carried by fleas that lived on black rats. The rodents spread the plague from China to Europe and it hit Britain in 1348.
Destroyer: A man carries a child suffering from the plague in 1349
However, according to historian Barney Sloane, the disease spread so quickly that the rats could not be to blame.
Dr Sloane said the increased spread of Black Death over the winter of 1348 coincided with a seasonal decrease in the number of both rats and fleas, which are susceptible to cold.
He also pointed out that rats are also killed by bubonic plague, but said there were no large deposits of rat bones from the 14th century.
The epidemic, which is reckoned to have claimed 75million lives worldwide, spread from person to person in crowded medieval cities, Dr Sloane said.
His findings even cast doubt on whether the Black Death was actually bubonic plague, and not something with similar symptoms.
gods punishment
Dr Sloane, formerly a field archaeologist at the Museum of London, said: ‘We ought to be finding great heaps of dead rats in all the waterfront sites but they aren’t there.
Human Plague — United States, 1993-1994
From 1944 through 1993, 362 cases of human plague were reported in the United States; approximately 90% of these occurred in four western states with endemic disease (Arizona, California, Colorado, and New Mexico) (1). During each successive decade of this period, the number of states reporting cases increased from three during 1944-1953 to 13 during 1984-1993 (Figure_1), indicating the spread of human plague infection eastward to areas where cases previously had not been reported. In 1993, health departments in four states reported 10 confirmed cases * of human plague to CDC; one case has been confirmed during 1994 **. This report summarizes information about the 11 cases of human plague reported during 1993-1994 and describes epidemiologic and epizootic trends of plague in the United States.
In 1993, the 10 confirmed cases of human plague were reported from New Mexico (six cases), Colorado (two), Texas (one), and Utah (one) (Table_1). Persons with plague infection were aged 22-96 years (median: 55.5 years); five were aged greater than or equal to 67 years. Six cases occurred among men. Five cases occurred during June-August, three during March-May, and two during September- November. Seven persons were exposed at their homesites, and one (a veterinarian) was exposed at work; exposure sites could not be determined for two cases. Seven cases were bubonic plague; two, primary septicemic; and one, primary pneumonic. Nine of the 10 patients recovered with antibiotic therapy; one patient died (Table_1).
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Man likely sickened by plague in critical condition in Bend
By Lynne Terry, The Oregonian
Rocky Mountain LaboratoriesAn electron micrograph depicts a mass of Yersinia pestis bacteria, which cause the plague. A man hospitalized in Bend is critically ill and is believed to have the disease which devastated Europe in the Middle Ages but is now rare.
A man hospitalized in Bend is likely suffering from the plague, marking the fifth case in Oregon since 1995.
The unidentified man, who is in his 50s, fell ill several days after being bitten while trying to get a mouse away from a stray cat. The man is now being treated at St. Charles Medical Center-Bend, where he was listed in critical condition on Tuesday.
“This can be a serious illness,” said Emilio DeBess, Oregon’s public health veterinarian. “But it is treatable with antibiotics, and it’s also preventable.”
The Black Death raged through Europe during the Middle Ages, killing about a third of the population. Today, the disease is rare, but the bacteria have never disappeared.
The man, who lives in rural Crook County, was bitten Saturday, June 2. He developed a fever a few days later. By Friday, June 8, he was so sick that he checked himself into St. Charles Medical Center-Redmond. He was later transferred to the larger facility in Bend.
Karen Yeargain, communicable disease coordinator with Crook County Health Department, said lab tests are being done to confirm whether the man has the plague, but she said he is suffering from classic symptoms.
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