title: An overview of plague in the United States and a report of investigations of two human cases in Kern county, California, 1995.
abstract: Plague was confirmed in the United States from nine western states during 1995. Evidence of Yersinia pestis infection was identified in 28 species of wild or domestic mammals. Thirteen of the plague positive species were wild rodents; 15 were predators/carnivores. Yersinia pestis was isolated from eight species of fleas. Seven confirmed cases of human plague were reported in 1995 (New Mexico 3; California 2; Arizona and Oregon 1 each). Five of the seven cases were bubonic; one was septicemic and one a fatal pneumonic case. Months of onset ranged from March through August. In California, during 1995, plague was recorded from 15 of the 58 counties. Over 1,500 animals were tested, of which 208 were plague positive. These included 144 rodents and 64 predators/carnivores. Two confirmed human cases (one bubonic and one fatal pneumonic) occurred, both in Kern County. Case No. 1 was reported from the town of Tehachapi. The patient, a 23 year-old male resident, died following a diagnosis of plague pneumonia. The patient's source of plague infection could not be determined precisely. Field investigations revealed an extensive plague epizootic surrounding Tehachapi, an area of approximately 500-600 square miles (800-970 square kilometers). Case No. 2 was a 57 year-old female diagnosed with bubonic plague; she was placed on an antibiotic regimen and subsequently recovered. The patient lives approximately 20 miles (32 km) north of Tehachapi. Field investigations revealed evidence of a plague epizootic in the vicinity of the victim's residence and adjacent areas. Overall results of the joint field investigations throughout the entire Kern county area revealed a high rate of plague positive animals. Of the numerous samples submitted, 48 non-human samples were plague positive.
authors.affiliation: California Department of Health Services, Vector-Borne Disease Section, Ontario 91764-5429, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Madon
authors.forename: J C
authors.initials: JC
authors.lastname: Hitchcock
authors.forename: R M
authors.initials: RM
authors.lastname: Davis
authors.forename: C M
authors.initials: CM
authors.lastname: Myers
authors.forename: C R
authors.initials: CR
authors.lastname: Smith
authors.forename: C L
authors.initials: CL
authors.lastname: Fritz
authors.forename: K W
authors.initials: KW
authors.lastname: Emery
authors.forename: W
authors.initials: W
authors.lastname: O'Rullian
mesh_terms: D000328:Adult; D000818:Animals; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010930:Plague / Q000453:epidemiology* / Q000662:veterinary; D014481:United States / Q000453:epidemiology