Plague and Tularemia in Colorado, 2014-2015
Jennifer House, DVM, MPH, DACVPM State Public Health Veterinarian Colorado Department of Public Health and Environment
PLAGUE
2 Plague • Yersinia pestis – Gram negative – Non-spore forming • Endemic in Western States only • Most cases occur in – Arizona – California – Colorado – New Mexico Reported Cases of Human Plague— United States, 1970-2012
http://www.cdc.gov/plague/maps/index.html Animals • Wildlife – Rodents such as Prairie dogs, Tree Squirrels, etc are highly susceptible • Companion Animals – Cats—highly susceptible – Dogs—more resistant but can still get sick – Pets can bring fleas into the home • Livestock – Mostly resistant Exposures of human plague cases in Colorado (n=65), 1959 – 2014
Unknown Cat 12% 12%
Squirrel Rabbit 3% 7%
Dog 7%
Woodrat Flea 2% 57%
Forms of human plague in Colorado (n=65), 1959 – 2014
7%
23%
70%
Bubonic Septicemic Pneumonic Colorado Human Plague Cases (n=69) by Year and Disease Type
9
8
7
6
5
4
3
2
1
0 1959 1961 1963 1965 1967 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015
Bubonic Disease Septicemic Disease Pneumonic Disease http://www.cdc.gov/mmwr/previ ew/mmwrhtml/mm6416a1.htm
10 Summer 2014
Tuesday, July 8 Epi notified of PCR + Yersinia Pestis
June 25 July July 8 Summer 2014
Tuesday, July 8 Epi notified of PCR + Yersinia Pestis A B
25 27 30 July 4 6 8 10
DOG C D CSU diag. dog with Yersinia Pestis Human Case
Animal Case 1 1 Cat Animal Exposure 3 10 0 Hospital Exposure 5 Cat 2 Veterinary Clinic Staff Exposure
Veterinary Clinic Client Exposure 4 Hosp. C Cat Personal Contact Exposure 1 6 5 Animal Diagnostic Lab A (6) Dog D (10) Hosp. D 5 C Hosp. E Hosp. A 0 5 2 Hosp. A Hosp. E 37 Hosp. B 0 3 9* B
9
8 3
Hosp. E 0
Slide Provided by Tri-County Health Department, Colorado TULAREMIA
14 Tularemia-What is it? • Rare disease – Often referred to as “Rabbit Fever” • Caused by the tiny, Gram negative bacterium Francisella tularensis • Can be present and persist for long periods in water, mud, and animal carcasses • Can affect both people and animals
2
16 Animals • Wildlife – Rabbits – Rodents—mice, voles, prairie dogs, squirrels, beaver, muskrats, etc. • Companion Animals – Cats can become very ill (life-threatening) – Dogs normally have self-limiting illness • Some may become very ill • Other Animals – Several animal species are susceptible to infection (particularly sheep) including livestock and birds
3 Transmission to Humans
• Direct contact with infected animals • Inhalation of aerosols • Inoculation into wounds • Ingestion of contaminated food or water • Vector-borne (ticks, flies) • Laboratory exposures
4 Human Forms of Disease
• Ulceroglandular • Glandular • Oculoglandular • Oropharyngeal • Typhoidal • Pulmonary
5 Clinical presentations of Tularemia, Colorado 2014 (n=16) Pneumonic Glandular or 31% Ulceroglandular 50%
Typhoidal (septicemic