HUMAN BUBONIC PLAGUE FROM EXPOSURE TO A NATURALLY INFECTED WILD CARNIVORE1

Abstract

Poland, J. D. (Ecological Investigations Program, CDC, P0 Box 551, Fort Collins, Colorado 80521), A. M. Barnes and J. J. Herman. Human bubonic plague from exposure to a naturally infected wild carnivore. Am J Epidemiol 97: 332–337, 1973.—In February 1972, a 19-year-old male Flagstaff, Arizona, college student developed typical symptoms of bubonic plague. The patient had skinned a bobcat 2 days earlier. This fact, coupled with the development of epitrochlear and axillary lymphadenopathy, led his physician to suspect tularemia, and he was treated accordingly. Yersinia pestis subsequently was identified from an aspirate of the patient's right epitrochlear lymph node and from the bone marrow and brain of the bobcat. The patient recovered without complication on broad-spectrwn antibiotic therapy. Two other students who assisted in the skinning remained asymptomatic as well as seronegative to fraction 1 of Y. pestis. Only one other plague case has been epidemiologically associated with a bobcat; in that case, appropriate samples from the animal for laboratory confirmation were unavailable. Other carnivores have been epidemiologically implicated as carriers of Y. pestis to humans, and their importance as sentinels of plague activity and as possible carriers of Y. pestis between rodent populations has been postulated or demonstrated in the past. This case constitutes the first confirmed direct association of an infected wild carnivore with the development of human plague in this country.