F2 - THECAPITAL,Sunday, October 2,2005
~ubonicplague still "instills fear
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vefY'now and then 1 run into bubonic
. of his feet had to be
E plague. . .
When I was in graduate school
the guy in the lab next door was growing
gallons of Yersinia pestis, the agent of
plague, for his thesis. Years later, in
ColohI'iio, I watched from behind the
relative safety of gloves and respirator
as' my, CDC colleagues picked plague,."
carrying fleas from wild rodents. Last fall,
in Central Asia, I visited some old Soviet
anti-plague institutes-where they had been
collecting and storing plague specimens
for decades-much to the consternation of
U:S. bioterrorism experts. Standing in the
airport in Astana one night, I stopped to
read a sign warning travelers about plague
(;f,Chum'a")in western Kazakhstan. Maybe
Denver International Airport should have
a similar sign.
Last month in Colorado, colonies of
prairie dogs started dying from bubonic
plague. The fate of prairie dogs might not
be of any great public health interest but
for the fact that prairie dog fleas jump
from animal to animal, animal to pet, and
sometimes animal to people. In December,
a 66-year-old man in Pueblo, Colo., died
from plague. He was the third case in 2004.
'You don't have to travel to any exotic
locations to find bubonic plague. It is
endemic in 17 western states. Sometimes it
can even show up in downtown Manhattan,
which it did in November'of 2002.
~ In the Manhattan case, a middle-aged
<;ouple traveled from New Mexico to New
York and suddenly fell ill. Both were
hospitalized and a diagnosis of bubonic
plague was made - briefly touching off
fears of terrorism. They were treated with
antibiotics, but the husband's condition
~eteriorated. He developed sepsis, renal
failure, respiratory distress and eventually
required dialysis and ventilation. Both
People- includingdoctors- fled the
amputated.
In the wild, bubonic
plague circulates
city just as frightened peasants had done
600"yearsago during Europe's greatest
outbreak of plague. Only 56 people died
naturally among in Surat, but India's economy took a $600
different rodent million hit from disrupted tra.vel, trade and
populations and their quarantines. ,
fleas. People usually The 14th century Black Death that
catch it from flea
decimated medieval Europe left indelible
bites, or from handling !narks on Europe's psyche, culture"art and
PATHOGENSipfected animals. One
genes - in the form of a genetic mutation,
BePEOPLE highly contagious which today confers some resistance to
By Edward 'form, called pneumonic HIV.
plague, can spread
McSweegan from person to person The memory of that infectious
through coughing. apocalypsewas so compellingthe Travelers
Symptoms of plague infection include Insuran'ce Company featured it in their
swollen glallds, fever, chills, headache and 1964World's Fair exhibit, "The Triumph
extreme fatigue. The infection is treated of Man." The exhibit's 13 historical audio
with antibiotics such as doxycycline and and visual dioramas depicted humanity's
Cipro. Untreated, the mortality rate can ascent from the African plains to outer
be 40 to 60 percent Pneumonic plague is space. The eighth exhibit, entitled, "The
usually 100percent fatal if not treated in Black Death," was a reminder of just how
the first 24 hours. rocky and uncertain was that ascent
There was an anti-plague vaccine, but If our rise from savannah scavengers
it is no longer manufactured in the U.S. It to star gazers has been fairly swift,
was crude and painful, and the only people then so too has the rise of Yersinia
who ever used it were laboratory scientists pestis. Recept genetic studies of the
w;orkingwith plague and veterinarians plague bacillus suggest it evolv:edfrom a
working out West relatively harmless bacterium..caned Y.
,Bubonic plague has a worldwide
distributiontnat includes the U.S.,much pseudotuberculosis within theJast 1,500
.'* to 20,000years. Genetically, that's the
of South America, southern Africa, India,
China ,and Central Asia. The U.S. averages blink of an eye. But that's time enough to
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about 13 cases a year. Worldwide, there spread from rat to rat and ship to ship.
'inight be 2,000 to 3;000 reported cases each Time enough to spread from Mongolia to
Manhattan. Time enough for us to make a
ye~r.. .'..'. ' ..~..
Giyen,plague's giQbaldistribution and new vaccine?
its maihtenance in wild rodents a.ndfleas,
it is not'likelyw~.will ever eradicate this Edward McSweegan has a Ph.D. in
terrifying infectIon. microbiologyand lives in Crofton.He
Andit~can bel>terrifying.Panic erupted works on and writes about infectious
in theIndian' cityof';''Surat in September disease issues. He may be contacted at
1994'aft,e~ pla.gue was discovered there. emcsweegan@verizon.net.