Cases of Cat-Associated Human Plague in the Western US, 1977-1998

Abstract

Exposure to cats infected with Yersinia pestis is a recently recognized risk for human plague in the US. Twenty-three cases of cat-associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat-associated human plague did not increase significantly during summer months. Plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat-associated human plague than at exposure sites for other cases. The risk of cat-associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment.

Pneumonic Plague Cluster, Uganda, 2004

“…This follows Butler's widely cited reviews, which state that pneumonic plague is "invariably fatal" if treated >20–24 h after illness onset ( 11 , 12 ) and cite the 1956 report of McCrumb et al ( 24 ). More recent reviews ( 25 ) and other literature ( 26 , 27 ) indicate that survival is possible even when treatment is initiated after 24 h, consistent with caregiver B2's survival. This caregiver received chloramphenicol, the only parenteral drug designated as a national standard plague treatment in Uganda ( 28 ), 29 h after illness onset, and survived without supportive care (i.e., mechanical ventilation or oxygen therapy).…”

Zoonotic Bacteria Associated with Cats

“…Handling infected cats could result in bubonic plague, primary pneumonic plague or primary septicemic plague. 29,30 The risk of cat-associated human plague is likely to increase as residential development continues in areas where the plague foci exist. 29 For prevention, controlling pet roaming, and implementing a flea control program are some of the important steps.…”

Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel: National Association of State Public Health Veterinarians: Veterinary Infection Control Committee 2015

“…13 There are > 50 zoonotic diseases of importance in the United States (Appendix 1). 14,15 Documented zoonotic infections in veterinary personnel include the following: salmonellosis, [16][17][18][19] cryptosporidiosis, [20][21][22][23][24][25] plague, 26,27 sporotrichosis, [28][29][30][31][32] methicillin-resistant Staphylococcus aureus infection, [33][34][35] psittacosis, [36][37][38][39] dermatophytosis, 40,41 leptospirosis, [42][43][44] bartonellosis, 45,46 and Q fever. [47][48][49][50] The American Association of Feline Practitioners published feline zoonoses guidelines in 2005 to provide veterinarians with educational information for clients and to highlight infection control procedures for small animal hospitals.…”