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Q&A: Everything you need to know about the plague

Kim Painter
Special to USA TODAY
Prairie dogs are among animals that can carry plague bacteria. A plague death in Utah this year was linked to a prairie dogs.  (AP Photo/Rick Bowmer)  ORG XMIT: UTRB102

While most people associate the plague with the middle ages, the disease persists, even in the United States. The latest case: an Oregon teen, likely infected by a flea bite, according to state health officials.

Here's what you need to know.

Q: What is the plague?

A: It's an infection, caused by the Yersinia pestis bacteria, according to the U.S. Centers for Disease Control and Prevention. There are three types: bubonic (concentrated in the lymph nodes), septicemic (in the blood stream) and pneumonic (in the lungs). The Oregon teen has been diagnosed with bubonic plague, the most common type, state health officials say.

Q: How common is plague?

A: In the United States, it's pretty rare, with an average of seven cases expected each year, CDC says. Most cases occur in the Southwest, particularly New Mexico, Arizona and Colorado. Oregon officials say they have seen just eight cases since 1995.

Q: How do you get infected?

A: Flea bites are the most common cause. Fleas typically pick up the bacteria from rodents, such as chipmunks, prairie dogs, ground squirrels and mice, CDC says. But people also can get sick from handling infected animals. In one Colorado case reported in 2014, three people were sickened by an infected dog and one additional person was infected by either the dog or one of the other people, a CDC investigation concluded.

Q: So it can spread person to person?

A: Only pneumonic plague – the kind that infects the lungs – can spread person to person, through direct, close contact, CDC says. The more common bubonic plague, the type reported in Oregon, does not spread from one person to another.

Q: What are the symptoms?

A: For bubonic plague, the symptoms include fever, chills, weakness and painful, swollen lymph nodes. Septicemic plague can cause abdominal pain, bleeding and shock. Pneumonic plague can cause shortness of breath, chest pain and cough. Symptoms appear one to six days after infection.

Q: What's the treatment?

A: Antibiotics. Before the antibiotic era, about two thirds of people died. Now it's just over 10% -- and is lowest for bubonic cases.

Q: What's the best prevention?

A: If you live an area where plague outbreaks occur, you should rodent-proof your home, keep your pets free of fleas and use insect repellents outside, according to the Mayo Clinic. There is no vaccine.

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