A resident of Deschutes County, Oregon, has been confirmed to have bubonic plague, marking the state’s first case of the rare bacterial disease since 2015.
It is believed that the individual contracted the infection from their cat. Dr. Richard Fawcett, the county’s health officer, announced that immediate contacts of both the patient and the pet were identified, informed, and given preventative medication, as per a statement released last week. The US Centers for Disease Control and Prevention (CDC) recommends common antibiotics such as gentamicin and fluoroquinolones as the primary treatment for plague.
The patient received treatment during the early phases of the disease and is considered to pose “little risk” to the public, the health department’s statement noted.
This incident has sparked discussions on the transmission of plague, a disease historically notorious for causing widespread fatalities in Europe during the Middle Ages, in contemporary times.
Dr. Dan Barouch, who is not connected to the Oregon case and serves as the director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, explained that the persistence of plague is due to its presence in an animal reservoir. The bacterium can infect wild animals, and since it’s not feasible to treat all animals in the wild, the disease continues to exist in nature. This results in a small number of human cases from time to time.
According to the CDC, the United States sees about seven cases of human plague annually, mostly in the rural regions of the Southwest and Northwest.
Plague is triggered by the bacterium *Yersinia pestis*. Typically, humans contract it through a bite from an infected flea or direct contact with an infected animal. Symptoms usually appear within two to eight days following exposure and can include painful, swollen lymph nodes, fever, headache, chills, and weakness.
If not identified and treated early, the disease can advance to more severe forms, such as infections of the bloodstream or lungs, making treatment more challenging, as noted by Deschutes County Health Services.
However, with modern medical advancements, “the plague is easily recognized, easily diagnosed, and easily treated” using antibiotics, according to Dr. Harish Moorjani, an infectious disease specialist at Northwell Health, who was not involved in the Oregon case. He emphasizes that, compared to the Middle Ages, the context today is vastly different, urging people to maintain perspective on the situation.
Dr. Dan Barouch, echoing this sentiment and also not involved in the Oregon incident, considers it “very unlikely” that the plague will see any significant spread from the individual case in Oregon, highlighting the effectiveness of current medical practices and public health measures.
Dr. Dan Barouch emphasized that the risk of the plague spreading beyond the individual case in Oregon is extremely low, especially since the patient and their close contacts have been treated. He advises the public not to worry but suggests minimizing risk by avoiding contact with rodents, fleas, and sick animals.
Cats are particularly susceptible to the plague because they struggle to control the bacteria, more so than dogs. Wild animals like squirrels, chipmunks, and other rodents are commonly infected in nature.
The Black Death, a pandemic caused by the plague in the Middle Ages, spread through flea-infested rats. The lack of antibiotics at the time led to widespread fatalities.
Barouch reassures that while the plague can be serious, it is now highly treatable with antibiotics if detected early. The fear associated with the Black Death in the Middle Ages is not warranted today. He advises anyone exhibiting symptoms such as fever, chills, and swollen lymph nodes to seek medical attention promptly, as early-stage plague is easily treatable.
Dr. Harish Moorjani highlighted that while there is a vaccine for Yersinia pestis, it’s generally recommended only for individuals at high risk, such as scientists who work directly with the bacterium. For the majority of the population, the vaccine is not necessary.
To maintain health and prevent plague infections, Moorjani advises practicing good hygiene both inside and outside the home to avoid contact with fleas and rodents. This includes leashing pets when outdoors and implementing effective flea control measures.
For those engaging in outdoor activities, precautions should be taken to prevent flea bites and to avoid handling dead animals, as recommended by the World Health Organization.
Moorjani emphasizes that simple hygiene practices and sensible personal protection can effectively prevent plague infections, underscoring the importance of basic preventive measures in safeguarding against the disease.
