Arizona resident dies from pneumonic plague, health officials say

The Guardian

4 days ago

A person has died from pneumonic plague in Coconino county, Arizona, the first such death there since 2007 – though officials are saying the death is unrelated to a recent die-off of prairie dogs in the area that may also be plague-related.
Health officials in Coconino county, which incorporates part of the Grand Canyon national park and lies north of Flagstaff, confirmed the death on 11 July.
Pneumonic plague, a severe lung infection, is rare in humans, with only about seven cases reported annually in the US. Unlike Bubonic plague, which killed millions in medieval Europe, it can be spread through airborne droplets.
While both are caused by the Yersinia pestis bacterium, bubonic plague is transmitted through rodent flea bites or contact with contaminated material – and it primarily affects the lymph nodes while pneumonic plague causes pneumonia and respiratory symptoms.
Authorities said the person, whose age, name and gender have not been released, had entered the Flagstaff Medical Center emergency department and died on the same day.
Hospital operator Northern Arizona Healthcare said in a statement that 'despite appropriate initial management and attempts to provide life-saving resuscitation, the patient did not recover'.
The death of the Coconino county resident marks the first recorded pneumonic plague death in the county in 18 years but not the most recent human plague case in Arizona – the state has recorded seven cases of plague since 2006.
Nationally, the US Centers for Disease Control and Prevention (CDC) say about seven human cases of plague are reported annually across the country, but only 15 plague deaths have been recorded in a 23-year period beginning in 2000. Most cases have been seen in rural areas in the west.
Typically, the CDC says, Yersinia pestis cycles naturally among wild rodents. And while most contract the disease though flea bites, they can become infected through exposure to sick pets, especially cats.
The plague death comes as officials in the county are investigating a sudden die-off of prairie dogs north-east of Flagstaff that may be caused by plague. County officials have said they don't think the human plague death and the prairie dog mortalities are related.
But they also issued guidelines about how to avoid contracting the plague, including avoiding contact with wild animals, touching sick or dead animals, camping near rodent burrows, or sleeping directly on the ground. They advise using insect repellent and tucking the cuffs of your trouser leg into your socks.
Coconino county health officials said the risk of human-to-human transmission of pneumonic plague is low. The last such transmission was in Los Angeles in 1924, according to National Institutes of Health (NIH) data.
Still, the symptoms of the Black Death – named for black spots that appeared on infected bodies – remain present. US health officials say plague symptoms typically appear within eight days after exposure and may include fever, chills, headache, weakness and muscle pain, and some may develop swollen lymph nodes (called 'buboes'), most commonly in the groin, armpits or limbs.
But the timing of the human plague death, and the prairie dog die-off, is raising concerns. Plague is one of many diseases endemic to the south-western US, including West Nile virus, hantavirus and rabies.
Trish Lees, communications manager for Coconino county, told the Arizona Republic the number of prairie dogs that have died was unknown.