The first case of bubonic plague in 8 years was recorded in Oregon: a man became infected from his cat.

A Deschutes County, Oregon man was diagnosed with the plague this week. This marked the state's first human case in more than eight years. The man probably became infected from his pet cat, which developed symptoms, reports NBC.

Photo: iStock.com/ManuelVelasco

People most often become infected with plague from the bites of fleas carrying Yersinia pestis, the bacterium that causes the disease. Pets can also become infected if they hunt rodents infected with plague or if they are bitten by an infected flea.

Pets can transmit the infection to humans through body tissue or fluids, such as through respiratory droplets from coughing or sneezing. They can bring fleas home, which then bite people.

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Cats are especially susceptible to plague because their bodies have a hard time ridding themselves of the infection, and they are more likely than some other pets to chase and catch rodents.

Distemper in dogs is much less common. However, in 2014, four cases of distemper were reported in Colorado among people who were in close contact with an infected pit bull terrier, including the dog's owner and two veterinary clinic employees.

Dr. Richard Fawcett, Deschutes County health officer, said the cat involved in the recent case was "very sick" and was found to have a draining abscess, indicating a "pretty serious" infection.

The owner's infection most likely began in a lymph node, called bubonic plague, Fawcett said. By the time the owner was hospitalized, the infection had already spread into the bloodstream. Fawcett said the patient "responded very well to antibiotic treatment."

However, he noted that the patient developed a cough during his hospital stay. This could be an early sign of pneumonic plague, the version that spreads among humans. But Fawcett isn't sure if the disease has progressed that far.

According to him, doctors gave the patient's relatives medicines out of precaution.

“If we know that a patient has bacteria in their blood, we have to be on the safe side,” Fawcett explained, noting that he “would be very surprised if we see any more cases.”

Before this incident, the last human case of plague in Oregon was in 2015: a teenage girl was believed to have contracted the disease from a flea bite while hunting.

Where is the plague found in the USA?

On average, there are about seven human cases of plague each year in the United States, mostly in the rural West. Cases are typically concentrated in northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon and western Nevada, according to the Centers for Disease Control and Prevention.

“We still don't have a good understanding of the persistence of plague in the environment in the western United States,” said David Wagner, director of the Center for Biodefense and Disease Ecology at the Pathogen and Microbiome Institute at Northern Arizona University. Fawcett said he doesn't understand why cases have cropped up periodically in central Oregon over the past dozen or so years.

“We just don’t have much of a flea problem in this part of the state,” he said, adding that plague-carrying rodents don’t seem to be a problem there.

Plague most often occurs in semi-arid forests and grasslands, where many species of rodents live, according to the Centers for Disease Control and Prevention. Fawcett said the person who recently became ill in Deschutes County lives in a suburban area and there is open land "not far" from the person's home.

Deschutes County Public Health advises pet owners to keep their pets on a leash when outdoors, give them flea control and take them to the vet if they become sick after interacting with rodents. The department asks people to avoid contact with rodents and to refrain from feeding squirrels and chipmunks.

When the plague is deadly

More than 80% of plague cases in the United States are bubonic, meaning the infection is limited to the lymph nodes. In people with bubonic plague, symptoms usually appear two to eight days after being bitten by an infected flea or coming into contact with an infected animal.

The most common symptom of bubonic plague is swollen and tender lymph nodes. Other symptoms include sudden fever, nausea, weakness, chills, or muscle pain. Doctors test for the infection on a blood or tissue sample and then treat the disease with antibiotics.

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According to Wagner, the bubonic plague, which killed more than a third of Europe's population in the 14th century, was significantly different from the threat that exists today.

“This infection is the same as in the 14th century. But there were no antibiotics then,” Wagner explained. “It’s now very easy to treat with simple antibiotics.”

But if bubonic plague is not treated early, bacteria can enter the bloodstream and cause septicemia or septicemic plague.

Typical signs of a bloodstream infection include severe weakness, abdominal pain, and bleeding from the nose, mouth, or under the skin. People's skin may even turn black, especially on the nose, fingers and toes.

Untreated bubonic or septic infections can lead to the pneumonic form of the disease, or pneumonic plague, which is often fatal.

These different forms of plague can coexist at the same time, and it is not entirely clear when the disease progresses from one stage to another or becomes contagious among people, Fawcett said. However, he is confident that the overall risk in Deschutes County is low.

“I don’t think this will pose any significant risk to our community,” he concluded.

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