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June 2000

Volume 30, Number 6
Clinical Infectious Diseases 2000;30:893–900
© 2000 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2000/3006-0007$03.00
DOI: 10.1086/313804

Cases of Cat‐Associated Human Plague in the Western US, 1977–1998

Kenneth L. Gage,1

 David T. Dennis,1

Kathy A. Orloski,1

Paul Ettestad,2

Ted L. Brown,3

Pamela J. Reynolds,3

W. John Pape,4

Curtis L. Fritz,5

Leon G. Carter,1 and

John D. Stein1

From the 1Bacterial Zoonoses Branch, Division of Vector‐Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins; 2Colorado Department of Public Health and Environment, Denver, Colorado; New Mexico Departments of 3Health and 4Environment, Santa Fe, New Mexico; and 5California Department of Health Services, California

Exposure to cats infected with Yersinia pestis is a recently recognized risk for human plague in the US. Twenty‐three cases of cat‐associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat‐associated human plague did not increase significantly during summer months. Plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat‐associated human plague than at exposure sites for other cases. The risk of cat‐associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment.

Received 18 May 1999; revised 4 December 1999; electronically published 13 June 2000.

Reprints or correspondence: Dr. Kenneth L. Gage, Centers for Disease Control and Prevention, P. O. Box 2087, Fort Collins, CO 80522 ().

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