Modern Day Plague Death in America

Its sad serendipity that I found out that an Arizona-based biologist working for the National Park Service, named Eric York, likely died of plague a few months ago. Fatalities due to modern-day plague (caused by the bacteria Y. pestis) are extremely rare, especially in America. I'm not even sure when the last death from plague in America was, although according to the CDC there are on average of 2800 plague cases worldwide and 13 of those are in the USA. Only 1 in 7 of plague cases in the USA are fatal.

It is suspected that York acquired the plague when performing a necropsy on a mountain lion that died of the infection. He began experiencing flu-like symptoms by October 30, just three days after the necropsy, and was found dead in his home November 2. This illustrates how quickly a Y. pestis infection can overwhelm the human body without a quick diagnosis and antibiotics to ward it off. With antibiotics (usually streptomycin or gentomycin) there is a 85% chance of survival, as opposed to 50-10% if left untreated. The picture below shows the Y. pesis bacteria in the blood.

i-7e43c4f9b1c568e08c5030942f610c72-plague in blood.jpg

As a side note, those two antibiotics I listed above are known to cause hearing loss via hair cell death.

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When I was in high school, my friends and I found out that the father of one of us had had the plague back in the early sixties. He was a wildlife biologist for the Department of the Interior and had been studying the collapse of a prairie dog community in South Dakota. Prairie dog die offs are often caused by plague as our friend's father found out the hard way. He almost joined his subjects in being called to the great prairie dog in the sky. Needless to say, his coolness rating among his daughter's nerdy friends went through the roof.

A frightening disease. I'm a little surprised, however, that selective pressures haven't preferred strains that kill people less quickly (allowing more opportunity for the host to infect others). Any microbiologists or epidemiologists have thoughts about this?

Many years ago my sister who was then an ER room nurse in SantaFe was given a course of antibiotics after treating a patient for plague. It is endemic in wildlife along the east slopes of the southern rockies.

I believe the squirrels in the SW often carry the plague. Or at least, there are signs everywhere saying "Don't pet the squirrels or you will die of the plague..." or words to that effect.

Saw a program on TV which argued that the medieval black death was a viral hemmoragic fever like ebola, rather than caused by Y. pestis. Study of a village of descendants of plague survivors found a high incidence of a particular gene. Said gene confers immunity to HIV when homozygous; renders HIV asymptomatic when heterozygous. Anyone know anything about this?

By Jim Thomerson (not verified) on 14 Jan 2008 #permalink

I did research on prairie dogs in Arizona this summer, and before going out in the field the PI gave me an extensive session on plague risk, how crucial it is to report any symptoms, etc etc. I didn't get the vaccine (apparently the side effects are pretty nasty in some people), but the university I was at did have it stocked at the med clinic.

To second Anne-Marie, any biologist or field tech that is working on or near prairie-dog colonies gets a stern warning about plague if their employer is competent. When I worked around p-dog colonies in Montana I witnessed plague wipe out a large, thriving colony virtually overnight. Amazing to see and very sad. A local man, somewhat of a hermit-type, supposedly had died of plague a few years prior after ignoring the symptoms for too long. We were told that at the slightest sign of any fever or flue-like symptoms, go to town immediately and insist that the doctor test for plague. Not a disease that most people are aware even still exists.

A frightening disease. I'm a little surprised, however, that selective pressures haven't preferred strains that kill people less quickly (allowing more opportunity for the host to infect others). Any microbiologists or epidemiologists have thoughts about this?

Humans are not the normal reservoir for Yersinia pestis. The selective pressures are stronger in the prevalent host(s). So killing a human quickly may not be the best if you primarily infect humans, that may not be the case if you primarily infect rodents and rarely end up in a human. Also, the mode of transmission is critical. As long as you can get out quickly (from another flea bite) it doesnt much matter if the host goes south quickly, in fact that may help increase spread since you'll be laying around half dead not swatting off fleas. If you are spread by sexual transmission, rapid killing is not wise.

Too many rats in the cage. This is bound to happen as we move well beyond carrying capacity!

By Edward in Flagstaff (not verified) on 15 Jan 2008 #permalink

I just came across a news article online stating that suggests a resurgence of the plague in various areas of the world. Here it is copied and pasted from aol...

***********************************************************
Plague, Medieval Scourge, On the Rise
Source: Reuters
Posted: 01.16.08
Aol News (Canada)

LONDON (Reuters) - Plague, the disease that devastated medieval Europe, is re-emerging worldwide and poses a growing but overlooked threat, researchers warned on Tuesday.

While it has only killed some 100 to 200 people annually over the past 20 years, plague has appeared in new countries in recent decades and is now shifting into Africa, Michael Begon, an ecologist at the University of Liverpool and colleagues said.

A bacterium known as Yersinia pestis causes bubonic plague, known in medieval times as the Black Death when it was spread by infected fleas, and the more dangerous pneumonic plague, spread from one person to another through coughing or sneezing.

"Although the number of human cases of plague is relatively low, it would be a mistake to overlook its threat to humanity, because of the disease's inherent communicability, rapid spread, rapid clinical course, and high mortality if left untreated," they wrote in the journal Public Library of Science journal PloS Medicine.

Rodents carry plague, which is virtually impossible to wipe out and moves through the animal world as a constant threat to humans, Begon said. Both forms can kill within days if not treated with antibiotics.

"You can't realistically get rid of all the rodents in the world," he said in a telephone interview. "Plague appears to be on the increase, and for the first time there have been major outbreaks in Africa."

Globally the World Health Organization reports about 1,000 to 3,000 plague cases each year, with most in the last five years occurring in Madagascar, Tanzania, Mozambique, Malawi, Uganda and the Democratic Republic of Congo. The United States sees about 10 to 20 cases each year.

More worrying are outbreaks seem on the rise after years of relative inactivity in the 20th century, Begon said. The most recent large pneumonic outbreak comprised hundreds of suspected cases in the Democratic Republic of Congo in 2006.

Bubonic plague, called the Black Death because of black bumps that sometimes develop on victims' bodies, causes severe vomiting and high fever. Victims of pneumonic plague have similar symptoms but not the black bumps.

Begon and his colleagues called for more research into better ways to prevent plague from striking areas where people lack access to life-saving drugs and to defend against the disease if used as a weapon.

"We should not overlook the fact that plague has been weaponized throughout history, from catapulting corpses over city walls, to dropping infected fleas from airplanes, to refined modern aerosol formulation," the researchers wrote.

By Tony Jeremiah (not verified) on 16 Jan 2008 #permalink

So plague is makinig a comeback?

Wonderful!

Given all of the ways one could die during the population collapse that follows overshoot of carrying capacity, I'd say that 2 - 3 days to die of plague is a heck of a lot more merciful than starvation or a number of other diseases that tend to go along with dieoffs.

And if you think this is callous, someone please invent a male pill that drops the sperm count to near-sterile levels while making men multiple-orgasmic That would be a world-saver, and it would have the added bonus of blowing away all traces of puritanical religious extremism.

Interesting. My long term partner's mother found out she had a natural immunity to Y. pestis when she entered the Intelligence branch of the US Army. She was required to have a battery of tests, one of which was an immunity screening and then boosters on anything she was not already immune to. They were rather puzzled when it came back as immune when she had never been vaccinated or exposed, until they learned where she was from. It turns out that families in her area (where her family had lived for 100+ years) have a high rate of genetic immunity. Reason unknown, but still interesting.

On digs we were always encouraged to lick (yeah lick)debris to determine wether or not it was bone or rock. I was frightened of hanta virus and refused - now you are telling me live critters are passing on the plague?

I have got to find a new line of work.

By archaeotart (not verified) on 20 Jan 2008 #permalink