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ASTMH: Case of Bubonic Plague Studied in Los Angeles

Researchers urge close alliance between clinicians and public health to manage such cases

MONDAY, Nov. 13 (HealthDay News) -- Even in the apparent absence of clear risk factors, bubonic plague can surface in an urban environment, according to research presented this week at the 55th annual meeting of the American Society of Tropical Medicine and Hygiene in Atlanta.

Anne M. Anglim, M.D., of the Keck School of Medicine-University of Southern California in Los Angeles, and colleagues conducted a case study of a 28-year-old Los Angeles woman who contracted bubonic plague.

During treatment, the patient strongly denied any direct animal contact or travel outside her urban locale, although she noted domestic incursions by rodents and feral cats. Given the lack of risk factors, the researchers immediately notified the Los Angeles County Department of Health Services and administered antibiotic prophylaxis to seven hospital employees.

The researchers state that the case has several implications: "(1) without relevant history, omission of plague as a diagnostic possibility is very likely, (2) use of universal precautions remains a vital safety practice, (3) early diagnosis is possible if blood smears are reviewed by skilled workers, (4) crucial risk factors were not quickly elicited, stemming largely from socio-cultural barriers. A close alliance between clinicians and public health is optimal for managing such difficult cases."


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