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Bubonic plague was diagnosed in a cat. The diagnosis was made by isolation of bacteria from a ruptured bubo and by demonstration of an antibody titer to Yersinia pestis. The cat was treated successfully with amoxicillin and streptomycin. The entire veterinary staff was treated prophylactically with tetracycline.
An outbreak of seven cases of bubonic plague in New Mexico was investigated. Clinical features were studied and correlated with field studies in an attmept to determine the source of infection in patients with indefinite histories of exposure. Most patients presented with fever, malaise, and an acute painful lymphadenitis (bubo). One death occurred in a patient with bubonic-septicemic plague complicated by meningitis due to Yersinia pestis. All patients lived in rural or semirural areas, and most had been in the general vicinity of their usual residence during the six days prior to onset of symptoms. The outbreak was associated with probable epizootics in rodents in two different areas of the state. One case was traced to direct hand contact with plague-infected rabbits. One patient developed insect bites after sleeping in the same bed with a flea-infested cat. Three of the other five patients had insect bites, presumably flea bites, but none of the five recalled contact with rodents or rabbits. Four of the five, however, had been in contact with dogs or cats that were later shown to have titers of antibody to Y. pestis. These findings provide further support for the hypothesis that contact with domestic dogs and cats may result in direct or indirect transmission of Y. pestis to humans.
A 62-year-old woman developed bubonic plague with an epitrochlear bubo one to two days after skinning two cottontail rabbits. The implicated rabbits were later recovered from the patient's freezer, and Yersinia pestis was isolated from marrows of both rabbits. Although human plague cases in the United States have occasionally been traced to exposure to wild rabbits, this is the first documentation of plague infection in the actual rabbits to which the patient was exposed. All reported cases of rabbit-associated plague in the United States were then reviewed. Eight cases were characterized by direct exposure to rabbit tissues. Seven of the eight cases occurred in adult males who had hunted rabbits during winter months in plague-endemic areas. These patients had upper extremity buboes, and the case-fatality ration for the group was 50%. Three other cases in which rabbit exposure was indirect or its role less clear, were also analyzed.
An 11-year-old boy developed axillary bubonic plague and plague meningitis 3 days after skinning a dead coyote near Albuquerque, New Mexico. The coyoto carcass was recovered 10 days later, and Yersinia pestis was isolated from spleen and marrow of the animal. This is the first report of human plague from exposure to a coyote. A review of experimental and epidemiologic studies suggests that severe plague infection in members of the family Canidae is unusual, and that the risk of acquiring plague from direct contact with coyote tissues is minimal. Nevertheless, certain precautions are outlined for persons working with wild coyotes.
An 8-year-old Navajo boy presented to the emergency department with fever and altered mental status. Because the child lived in a plague-endemic area of the southwestern United States, antibiotics effective against Yersinia pestis were administered rapidly. Buboes were appreciated on physical examination, and the diagnosis of bubonic plague was confirmed by positive blood cultures. Characteristics and treatment of Yersinia pestis infection are discussed. The need for a high index of suspicion for the presence of plague in patients who present to the ED and who reside or have recently traveled in a plague-endemic area is emphasized.
We studied a protein antigen, designated pH 6 Ag, that has the same regulation of expression as the previously described Yersinia pestis pH 6 Ag. Monospecific antiserum to this antigen recognized several proteins, ranging from 15 to over 75 kilodaltons (kDa), which were strongly expressed when Y. pestis was cultivated at 37 degrees C and pH 6 but were expressed weakly, if at all, at 37 degrees C and pH 8 and at 26 degrees C. The antigen appeared to be composed of aggregates of a 15-kDa subunit. Escherichia coli minicell analysis and Western blotting (immunoblotting) of minicell extracts containing the cloned pH 6 Ag locus revealed that a 1.7-kilobase-pair (kb) region of Y. pestis chromosomal DNA produced 16- and 15-kDa immunoreactive proteins. We used transposon mutagenesis of the pH 6 Ag-coding region to demonstrate that the 16- and 15-kDa polypeptides were produced by the same cistron. The pH 6 Ag structural gene, psaA, was located within a 0.5-kb region of DNA. A Tn10lacZ transposon insertion 1.2 kb upstream of the psaA locus but outside the psaA transcriptional unit caused decreased expression of pH 6 Ag in both E. coli and Y. pestis and defined the psaE locus necessary for maximum pH 6 Ag expression. This locus itself was not regulated by temperature or pH. However, psaA remained responsive to both of these environmental signals in a Y. pestis psaE mutant. Mutation of either psaE or psaA resulted in at least a 100-fold reduction in the intravenous 50% lethal dose of Y. pestis in mice. Accordingly, pH 6 Ag is involved in the pathogenesis of bubonic plague.
After one week of nonspecific symptoms, pneumonia and an extremely tender and enlarged cervical lymph node developed in a 12-year-old girl who lived in an area of New Mexico known to have plague-infected rodents. Cultures from an aspirate of the node, her sputum, and blood all showed growth of Yersinia pestis. She was treated successfully with aminoglycosides and tetracycline. As the pneumonia resolved, areas of consolidation were replaced by cavitary lesions.
In A.D. 1346 some 100 million people inhabited Europe, northern Africa and the Near East. Five years later 25 million were dead--victims of the Black Death. The plague kept reappearing, but the epidemics did not spread as widely: apparently a new and milder strain of Yersinia pestis evolved that made at least some people immune to the virulent strain.
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A 19-year-old man, recently returned from a 10-day military exercise in central California, had acute onset of shaking chills, headache, and bilateral inguinal adenopathy after having been bitten by insects on his lower extremities. He had exquisitely tender inguinal and femoral nodes bilaterally. Needle aspirate from an inguinal node grew Yersinia pestis. The patient was treated with streptomycin and chloramphenicol and did well.
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Plague has been known from countries surrounding Rhodesia from as early as 1935, but was first reported from Rhodesia in 1974. Part of our investigation of the complex ecosystem involving Yersinia pestis is critical assessment of the evolutionary status of natural populations belonging to formal, taxonomic species of implicated rodents. We present data on chromosomal and hemoglobin variation in sympatric populations and laboratory produced hybrids that give unequivocal evidence for at least two biologicql species in the taxon Praomys (Mastomys) natalensis. We argue for the usefulness of the biological species concept as a basis for any ecological investigation into pathogen biology.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.