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Cause:
Bacterium Yersinia pestis
Illness and treatment:
Plague causes three clinical syndromes: bubonic (fever, headache, nausea and unilateral
lymph node swelling); septicemic (bacteremia and multi-organ system failure); and
pneumonic (pneumonia). A patient may have several syndromes. About 14% of plague cases in the
United States are fatal. Treatment is with antibiotics and supportive care.
Sources:
Wild rodent populations are the natural reservoir where plague is maintained by fleas. Humans are
infected through flea bites, handling tissues from infected animals, or respiratory droplet spread
from animals or people with pneumonic plague.
Prevention:
Avoid contact with sick or dead wild animals, rodent-proof houses, prevent pets from contracting
fleas, and use repellents on skin and clothing when outdoors.
Recent Washington trends:
Serologic sampling of 6,781 wild carnivores collected between 1975 and 2009 in Washington showed 3.3%
seropositivity but human infections are rare: the last reported case was an animal trapper in Yakima
exposed while skinning a bobcat in 1984. In neighboring Oregon, 2 persons living in the southern
part of the state were diagnosed with plague in 2010.
2010:
No human cases of plague were reported; however, a laboratory technician in Washington who
worked with a specimen from an Oregon plague case received prophylaxis for a laboratory exposure.
Purpose of Reporting and Surveillance
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To assist in the diagnosis and treatment of cases
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To identify potentially exposed close contacts, health care workers and laboratory personnel
and to provide counseling
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To identify sources of transmission (e.g., wild rodents or other animals) and to prevent further
transmission from such sources
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To raise the index of suspicion of a possible bioterrorism event if no natural exposure source is identified
Legal Reporting Requirements
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Health care providers:
Immediately notifiable to local health jurisdiction.
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Health care facilities:
Immediately notifiable to local health jurisdiction.
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Laboratories:
Yersinia pestis immediately notifiable to local health jurisdiction; specimen submission required —
culture or other appropriate clinical material (2 business days).
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Veterinarians:
Suspected human cases notifiable immediately to the local health jurisdiction;
animal cases notifiable to Washington State Department of Agriculture (see:
http://apps.leg.wa.gov/WAC/default.aspx?cite=16-70).
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Local health jurisdictions:
Suspected and confirmed cases are immediately notifiable to the Washington State Department of
Health (DOH) Communicable Disease Epidemiology (CDE) (1-877-539-4344).
If bioterrorism is suspected, case must be immediately reported to DOH: 1-877-539-4344
Last update
December 2011 |
