The Centers for Disease Control and Prevention is trying to determine how prevalent the plague is in a rural area of northern Colorado where a 16-year-old boy died of the disease.
Taylor Gaes of Livermore died June 8, but the cause was only made public late Friday when health officials, at the urging of the boy’s parents, put out a warning to make sure others who may have visited his family’s rural home northwest of Fort Collins hadn’t been sickened by fleas that could have infected him...
Gaes likely was infected with a rare form of the disease, septicemic plague, by fleas that put the bacteria directly into his blood stream, making it difficult to spot in time to stop its spread...
Cases of the plague are rare and deaths are even rarer. Nationally, an average of seven human plague cases is reported each year, with an average mortality rate of 11 percent, according to the CDC.
The most common form, bubonic plague, affects the lymphatic system, producing tell-tale swelling of the lymph nodes. All types can be treated and cured when antibiotics are given soon after infection, but all of them are deadly when treatment is delayed.
See: http://www.washingtonpost.com/national/health-science/cdc-tests-for-plague-in-northern-colorado-after-teens-death/2015/06/23/6c5437b6-1a0a-11e5-bed8-1093ee58dad0_story.html
Courtesy of: http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/52276?isalert=1&uun=g906366d4199R5793688u&xid=NL_breakingnews_2015-06-24
The first death came in June — 16-year-old Taylor Gaes from Fort Collins, Colo., beloved for his quiet passion and wicked fastball. The second was announced Wednesday — an unidentified adult from the southern part of the state.
ReplyDeleteBoth are thought to have died from septicemic plague, a rare and deadly form of the disease that slaughtered millions in the Middle Ages but is now mostly an isolated — if tragic — curiosity. A scant seven plague cases are reported in the U.S. each year, most of them easily treatable with antibiotics. These are the first deaths in Colorado in more than a decade, and in Gaes’s case at least, the disease was only deadly because doctors didn’t recognize it as plague.
The two deaths are both rarities, and neither case seems likely to spread to anyone else…
Plague comes in three forms — septicemic (focused in the bloodstream), pneumonic (an infection in the lungs) and the most notorious and most common, bubonic (which causes the characteristic boils) — all caused by the bacteria Yersinia pestis. It’s capable of spreading from human to human, but is most often carried by fleas, usually on the backs of rats, gerbils or occasionally cats and dogs...
When a disease spreads beyond the population where it’s endemic (in this case, rodents), it’s called an epizootic. And Colorado is starting to see more of them. Last year, a pit bull was found to be the root cause of a minor plague outbreak that infected four people. All the victims survived, though the the dog did not...
Officials are blaming the weather. For the past two years, some parts of the state (the ones that aren’t parched with drought) have seen a wetter spring than usual. That leads to particularly lush vegetation, which in turn promotes larger rodent populations. The consequence? Colorado had eight cases of plague in 2014 and four this summer, including the two deaths…
A 2012 report from the U.S. Geological Survey found that, between 1969 and 2000, 75 percent of plague epizootics (cases where the disease spread beyond the animals where it is endemic and into other species) happened during an El Niño year, when the winters were warm and wet. That could change with global warming, the report said — as the Southwest gets hotter and drier, the rodents and their fleas might flee, spreading the disease north to Wyoming and Idaho.
Or they might not. As science writer Elizabeth Kolbert pointed out in the New Yorker, the PNAS gerbil study shows how complex the relationship between climate and public health can be.
“If the new PNAS study is correct, then millions in Europe died because the climate conditions were sometimes favorable for these rodents a quarter of the way around the world,” she wrote. “The indirect nature of the connection makes it hard to foresee what warming will mean for human health, which — in case you needed it — is another thing to worry about.”
http://www.washingtonpost.com/news/morning-mix/wp/2015/08/06/critters-climate-and-two-plague-deaths-in-colorado/
Courtesy of: http://www.medpagetoday.com/PrimaryCare/GeneralPrimaryCare/52953?isalert=1&uun=g906366d4406R5793688u&xid=NL_breakingnews_2015-08-06
Without two genetic mutations, the Black Death would never have been more than a minor gastrointestinal annoyance. According to a study published Tuesday in Nature Communications, Yersinia pestis -- the bacterium that causes the three main forms of plague and has killed millions throughout history -- could never have been a killer if not for these mutations, which occurred relatively recently.
ReplyDeleteThere are actually three kinds of plague that Y. pestis can cause; bubonic, pneumonic, and septicemic. But pneumonic plague, which infects the lungs and killed millions as "The Black Death" during the 1300s, is considered the most serious, and has a fatality rate of close to 100 percent. Even today, when individual cases of the plagues are rare but not unheard of, the pneumonic plague often goes undetected for too long -- easily mistaken for the flu -- for antibiotics to be of use.
But how did the Black Death become so deadly?
In the new study lead by microbiologist Wyndham Lathem, researchers from the Northwestern University Feinberg School of Medicine found that a single gene for producing the protein Pla (acquired by Y. pestis early in its evolution) allowed the bacterium to infect the lungs. Until then, based on tests of bacteria altered to lack the gene, it may have been able to colonize the lungs, but wouldn't have caused a serious infection there.
“Almost all ancestral strains of Y. pestis carry the gene for Pla, but there still exist a few that represent ancestral Y. pestis just prior to acquistion of Pla," the study authors wrote in an article for The Conversation. "We were able to test if these pre-Pla strains were able to cause pneumonic plague – and they did not. But as soon as Y. pestis picked up this gene, the bacteria could cause epidemics of pneumonic plague.”
Traditionally, researchers have thought that lung infection was one of the last tools the plague added to its arsenal. But this new research suggests that it took its baby steps as a lung infection, since it probably had the Pla gene quite early in its 5,000-10,000 year lifespan.
But it was a mutation to that gene that gave the plague real potential.
Previous research had shown that a mutation in the Pla gene changed how Y. pestis expressed it, but Lathem and his colleagues tested how that shift changed the disease in rats.
According to their observations, the modern version of the Pla gene allows the bacterium to infect deep tissues in the body 100 times more effectively. In other words, the mutation makes the plague bacteria much better at infecting the bloodstream and causing a full-body infection.
That second mutation almost certainly occurred just before the first major outbreak of plague 1,500 years ago. The researchers believe that this tiny mutation made the infection spread quickly enough to hit critical mass and cause epidemics…
Even though the plague is still out there, no one expects it to make another genetic leap and turn super-deadly again. But it's important that scientists understand just how swiftly a harmless bacterium can turn itself into a killer -- because it could certainly happen again.
http://www.washingtonpost.com/news/speaking-of-science/wp/2015/07/01/how-the-black-death-turned-from-a-tummy-bug-to-a-deadly-plague/
At 6-foot-4 and 210 pounds, Gaes was considered an excellent college baseball prospect, according to the Post. He was a varsity pitcher and starting first baseman at only 15, as well as a great hitter, the paper reported...
ReplyDeleteAn average of seven human plague cases are reported each year across the country, according to the Centers for Disease Control and Prevention. During Bubonic plague, bacteria grow inside a person’s lymph nodes, according to the CDC. Septicemic plague occurs when plague bacteria multiply in the blood, the CDC states, and Pneumonic plague infects the lungs.
Haigh said the teenager had the potential for a “brilliant sports career.”
Gaes’s death remains troubling for those who knew him because of the speed of the teenager’s sudden demise. Health officials remain perplexed because he didn’t exhibit swollen lymph nodes, a characteristic marker of the illness that would have alerted officials sooner, Katie O’Donnell, a Larimer County Health Department spokeswoman, told the Los Angeles Times.
Instead, the Times reported, Gaes complained of fever and muscle aches — common flu symptoms...
To reduce the chance of death, antibiotics must be given within 24 hours of the appearance of the first symptoms, the agency recommends.
A week before he died, Taylor was in superb health, his coach told the Post. But two days after first getting sick, Gaes’s condition worsened quickly. His family was forced to leave a Colorado Rockies game in the fifth inning because of his pain, according to USA Today.
His symptoms appeared to improve later that evening after his parents put heating pads on his back, but the next morning he woke up his parents to tell them he’d just coughed up blood, the paper reported.
Family members tried to rush him to the hospital 20 miles away, but it was too late. The teenager stopped breathing with five miles to go.
http://www.washingtonpost.com/news/morning-mix/wp/2015/06/21/star-teenage-athlete-dies-after-flu-symptoms-turn-out-to-be-plague/
Clinicians should consider human plague in any patient who has compatible symptoms and has reasonable risk factors, according to the Centers for Disease Control and Prevention. Key risk factors include residing or traveling in the western United States, recent proximity to rodent habitats, or direct contact with rodents or sick domestic animals.
ReplyDeleteNatalie Kwit, DVM, from the Epidemic Intelligence Service and the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues released their findings in an article published online August 25 in the Morbidity and Mortality Weekly Report.
Since April 1, 2015, a total of 11 cases of the infection have been found in residents of six states: Arizona (two), California (one), Colorado (four), Georgia (one), New Mexico (two), and Oregon (one). Investigators have linked two cases in Georgia and California with exposures at or near Yosemite National Park in the Sierra Nevada Mountains of California.
Overall, three patients (aged 16, 52, and 79 years) have died.
http://www.medscape.com/viewarticle/850080?src=wnl_edit_medn_wir&uac=60196BR&spon=34&impID=807387&faf=1
“All three of New Mexico’s human plague cases this year have been septicemic plague, which is less common and more difficult to recognize,” said Department of Health Secretary Retta Ward, MPH.“I urge all health care providers who see patients with a fever of unknown origin, and who are presenting from plague endemic areas of the state to consider plague in their diagnosis.”
ReplyDeleteSepticemic plague accounts for approximately 20-25 percent of New Mexico cases. Septicemic plague has no specific features or detectable swollen lymph node (bubo) by which it can be distinguished from other infectious diseases, although abdominal pain, vomiting and diarrhea are common.
http://dgalerts.docguide.com/new-mexico-usa-plague-septicemic?nl_ref=newsletter&pk_campaign=newsletter
The New Mexico Department of Health announced today, 23 Sep 2015, a laboratory-confirmed case of plague in a 73-year-old woman from Santa Fe County. The case was confirmed at the Department of Health's Scientific Laboratory Division. This is the 4th human case of plague in New Mexico in 2015 and the 2nd in Santa Fe County. The woman was hospitalized and is back home recovering. The other cases in the state occurred in a 52-year-old woman from Santa Fe County, who died from the illness, and in a 65-year-old man and a 59-year-old woman, both from Bernalillo County, who have recovered.
ReplyDelete"This is the 4th case of plague in New Mexico with the patient presenting clinical signs of septicemic plague," said Department of Health Secretary Retta Ward, MPH. "Though septicemic plague is less common and harder to recognize than the more common form of bubonic plague, health care providers need to consider plague in their diagnosis when the patient has a fever of unknown origin and when the patient is from plague endemic areas of the state."
Septicemic plague accounts for approximately 20-25 percent of New Mexico cases. No detectable swollen lymph node (bubo) is found.
http://dgalerts.docguide.com/new-mexico-usa-plague-septicemic-1?nl_ref=newsletter&pk_campaign=newsletter