Bubonic Plague: An Ancient Fear of the Modern Era Still Persists

The availability of modern antibiotics has made bubonic plague no longer a fatal disease

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The bubonic plague, often seen as a relic of the past, continues to afflict thousands of people globally each year, albeit with relatively rare cases in the US.

Recently, Oregon confirmed its first case in eight years, likely transmitted by a domestic cat displaying symptoms as well. Richard Fawcett, a health officer in Oregon, stated that the patient fell severely ill after contracting the plague from their pet.

Typically, symptoms of this infection resemble those of the flu, such as fatigue, fever, chills, and headaches. However, the recent Oregon case progressed to a rare outcome known as a “bubo,” a draining abscess.

Fortunately, modern antibiotics have transformed the prognosis of the bubonic plague. Yersinia pestis, the bacterium responsible, is rarely fatal if treated promptly.

The patient in Oregon is reportedly responding well to treatment, and measures have been taken to prevent further spread among close contacts.

The exact transmission route from the cat to the owner remains unclear. It’s possible that the cat carried infected fleas home, exposing the owner, or that the owner came into contact with the cat’s contaminated fluids.

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Y. pestis primarily infects small mammals and fleas and can cause bubonic plague or more severe forms, depending on how it spreads to humans.

While bubonic plague primarily affects the lymphatic system, causing swollen and painful lymph nodes, it can progress to infect the lungs, as indicated by the patient in Oregon developing a cough.

Although the plague was first identified in the US in the early 20th century, it has persisted in rural rodent populations, resulting in occasional outbreaks.

Today, most US cases occur in rural regions, particularly in the midwest and northwest, with an average of seven cases reported annually.

Although the plague remains a threat in various parts of the world, particularly in regions with animal reservoirs and dense human populations, such as the Democratic Republic of the Congo, Madagascar, and Peru, it no longer poses the same global threat as historical outbreaks.

Despite its diminished impact compared to historical pandemics like the Black Death, a single case in the US can still garner significant attention, underscoring the enduring legacy of the disease.

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