New York City Visitors Have Plague

Officials say they got it in New Mexico, and pose no risk to others

THURSDAY, Nov. 7, 2002 (HealthDayNews) -- Health officials said the apparent bubonic plague that surfaced this week in a New Mexico couple visiting New York City can't be passed from person to person and almost certainly was caught from flea bites before they left home.

The patients are a 53-year-old man and likely his 47-year-old wife, too, who live in Santa Fe. Plague was detected last summer in a wood rat found in their backyard, said Eddie Binder, a spokesman for the New Mexico Department of Health. Although the woman's case has not yet been confirmed, "she has all the symptoms," Binder added.

Both are being treated at a Beth Israel Medical Center, North, where they are being kept in isolation, said Mike Quane, a hospital spokesman. Quane said the man is in critical condition. "It's still serious," he said.

The incubation period for black plague is between two and seven days. Since the couple arrived in New York on Nov. 1, and went to the hospital two days later with symptoms -- including high fever and swollen lymph nodes -- officials said they must have been infected prior to arriving in the city. If the latest two cases are confirmed, they would mark the first in New York City in more than 100 years.

The news, and the initial official response, echoed the first days of last year's anthrax attack, which began in Florida with the illness of a newspaper editor. Health and Human Services Secretary Tommy Thompson told reporters at the outset that the case was "isolated," an assessment that was soon proved incorrect.

Yersinia pestis, which causes plague, is one of the microbes experts fear may be in the armamentarium of biological terrorists. However, the fact that it must be spread by fleas makes it an inefficient weapon, said Thomas Johnson, director of respiratory therapy at Long Island University. "For a terrorist it's very difficult. For a government with delivery systems it could be done," Johnson said. The Japanese dropped canisters of grain with plague-infested fleas over China in 1940, according to the Monterey Institute of International Studies.

Before the arrival of antibiotics, the black death -- named for the gangrene and dark color of the buboes, or swollen lymph glands, that mark the disease -- was the world's leading infectious killer. Outbreaks claimed 25 million people in Europe in the mid-14th century alone. Now, however, only about 10 percent of those infected die.

While most plague is spread from fleas to humans, when the infection reaches the lungs it can pass from person to person. This so-called "pneumonic" form of the disease is even rarer than bubonic plague, with the last known cases in the United States occurring in Los Angeles in the 1920s, according to the National Institutes of Health.

The U.S. Centers for Disease Control and Prevention receives reports of about a dozen cases of plague a year, almost all from rural regions of the West and Southwest. Binder said New Mexico had one case of plague last year and one the year before. The infested wood rat from the couple's backyard was the only rodent with the disease found in a surveillance of the city, he added.

What To Do

For more on plague, try the U.S. Centers for Disease Control and Prevention. For more on bioterrorism, try the U.S. Food and Drug Administration.

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