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Plague Fact Sheet
CLINICAL FEATURES
- Bubonic plague: enlarged, tender lymph nodes, fever, chills and
prostration
- Septicemic plague: fever, chills, prostration, abdominal pain,
shock and bleeding into skin and other organs
- Pneumonic plague: fever, chills, cough and difficulty breathing;
rapid shock and death if not treated early
ETIOLOGIC AGENT
- Yersinia pestis - bacillus
INCIDENCE
- In the U.S., 1 to 40 cases reported annually (avg = 13 cases) by western
states, 1971-1995
- Worldwide, 2861 cases reported by 10 countries to WHO in 1995
SEQUELAE
- Rare, consequences of disseminated intravascular coagulation, lung damage
- Mortality 50-90% if untreated; 15% when diagnosed and treated
COSTS
TRANSMISSION
- Flea-borne, from infected rodents to humans
- Direct contact with infected tissues or fluids from handling sick or
dead animals
- Respiratory droplets from cats and humans with pneumonic plague
RESERVOIRS
- Primarily wild rodents in U.S. (especially rock squirrels, ground squirrels,
prairie dogs, other burrowing rodents)
- Commensal rats may be important elsewhere
RISK GROUPS
- In the U.S., persons exposed to rodent fleas, wild rodents, or other
susceptible animals in enzootic areas of western states
- Most cases occur in southwestern states of NM, AZ, CO, and in CA
- Highest rates in Native Americans, especially Navajos; other risk groups:
hunters; veterinarians and pet owners handling infected cats; campers or hikers entering areas with outbreaks of animal plague
SURVEILLANCE
- National Notifiable Disease Surveillance System (NNDSS) for animal plague
surveillance, for reports of human cases, and laboratory testing of fleas, animal tissues and serum specimens, and serosurveys
of carnivores
- CDC, Fort Collins, is a WHO Collaborating Center for Reference and Research
on Plague Control, and reports all human plague cases in the U.S. to WHO
OPPORTUNITIES
- Increased self-sufficiency of state and county public health labs
- Expanded active surveillance through carnivore serosurveys and application
of geographic information systems (GIS) to surveillance programs
- Increased education of public and health professionals
- Collaborative applied research on plague prevention and control with
other federal, state, and local health agencies, including application of GIS to surveillance
RESEARCH
- Ecology-based prevention and control strategies
- Improved diagnostic reagents and methods
- Development of potential vaccine candidates
- Risk factor identification using landscape ecology and epidemiology
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