Arizona plague death: Close contacts of late patient given antibiotics

FLAGSTAFF, Ariz. - There is still a lot of unknown surrounding a deadly case of the plague in northern Arizona, but on July 14, officials are revealing the steps they have taken to prevent any future spread of the disease.

The backstory:

According to officials with Northern Arizona Healthcare, a person showed up with symptoms at the Flagstaff Medical Center, and died later that same day. The person tested positive for Yersinia pestis, which is the bacteria that causes the Plague.

On July 12, officials with the Arizona Public Health Association said there is no need to worry about the illness. Will Humble with the organization said that when many hear the word ‘plague,’ their minds often jump to the Bubonic Plague from the 1300s, which Humble stated, "actually killed between a third and a half of Europe."

However, Humble explained that the word has a different meaning today.

"That is never going to happen in the rest of human history," said Humble. "We've figured out how to limit this disease."

County officials release details on deadly case

On July 14, we received more information about the case from officials with the Coconino County Health and Human Services, including a timeline of the matter.

County officials detail steps taken to prevent spread

What We Now Know:

We asked Abrazo Health Infectious Disease Expert Dr. Sami Hoshi on whether it takes a long time to confirm a plague case.

"Yes," Dr. Hoshi said. "They need to send it to a specific lab. Not all hospitals can do the test."

We also know now that prairie dogs are not the culprit, as Coconino County Health and Human Services officials say the recent die-off in northeast Flagstaff was an unrelated matter.

While county officials are not confirming the victim's identity, they did say that while they waited for confirmation on the cause of death, they also took steps to control the spread.

"Pending confirmatory test results, [Coconino County Health and Human Services] began several essential activities to control the potential spread of disease. These included case identification and investigation, contact tracing, implementing interim control measures, and dissemination of appropriate prevention information," read a portion of a statement we received from CCHHS.

Officials with CCHHS also said "preventive antibiotics were administered in some instances, following consultation with [the Arizona Department of Health services] Bureau of Infectious Disease."

What we don't know:

County officials are still investigating how the plague spread.

With regard to the "preventive antibiotics" that were administered, it is unknown how many people received such treatments, nor do we know if any were showing symptoms when the antibiotics were being administered.

Expert Perspective:

We asked Dr. Hoshi if hospitals have Plague antibiotics on hand.

"The good news is the antibiotics they usually treat with is available in usually 99% of hospitals. They should have the medication needed for treatment of the Pneumonic Plague," said Dr. Hoshi.

What is the Plague?

Dig deeper:

According to the Cleveland Clinic, the plague usually spreads through bites from fleas that previously bit an infected animal. The website notes there are three types of plagues: Bubonic, Septicemic, and Pneumonic. They are each named for the part of the body that gets a Yersinia pestis infection.

"While it still exists, plague is extremely rare now. Worldwide, 1,000 to 2,000 people are diagnosed with plague every year. Only about seven cases are reported in the U.S. each year," read a portion of Cleveland Clinic's website.

Symptoms of the plague include:

• Fever
• Chills
• Nausea, vomiting, and diarrhea
• Weakness and fatigue
• Dizziness

To prevent exposure to plague, Coconino County Health and Human Services recommends: 

• Avoid contact with wild animals. Never feed or handle wild rodents and avoid areas where they are known to live. Do not touch sick or dead animals.
• Avoid fleas. Use an insect repellent containing 20-30 percent DEET and tuck pant cuffs into your socks to help prevent flea bites.
• Use veterinarian-approved flea treatments on pets, keep them on a leash, and keep them out of areas known to be inhabited by wild rodents.
• Report prairie dog die-offs. Prairie dogs are highly susceptible to plague but are not considered a long-term reservoir of the disease. They typically die off quickly after infection, making them an indicator species for plague presence. Active prairie dog colonies are not harmful but a sudden reduction/die-off in prairie dog colonies may indicate the presence of disease. Those noticing a sudden die-off of rodents or rabbits within Coconino County are urged to contact CCHHS Animal Services at 928-679-8756 or Environmental Health at 928-679-8760.
• Prevent rodent infestations by removing brush, rock piles, trash, and lumber from around homes and outbuildings. Store food in rodent-proof containers.
• Do not camp next to rodent burrows and avoid sleeping directly on the ground.
• Seek veterinary care for sick pets. If your pet shows symptoms such as a high fever or swollen lymph nodes, is lethargic, has a loss of appetite or develops a cough or eye drainage, contact a veterinarian immediately. It is recommended to call before visiting the veterinarian’s office for instructions to help limit exposure to potential disease.
• Be aware that cats are highly susceptible to plague and while they can get sick from a variety of illnesses, a sick cat (especially one allowed to run at large outside) should receive care by a veterinarian for proper diagnosis and treatment.

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