CAT-TRANSMITTED FATAL PNEUMONIC PLAGUE IN A PERSON WHO TRAVELED FROM COLORADO TO ARIZONA

Plague, primarily a disease of rodents and their infected fleas, is fa tal in 50% of infected humans if untreated. In the United States, huma n cases have been concentrated in the southwest. The most common modes of plague transmission are through flea bites or through contact with infected blood or tissues; however, primary pneumonic plague acquired from cats has become increasingly recognized. We report on the case i nvestigation of a patient, presumably exposed to a plague-infected cat in Colorado, who presented with gastrointestinal symptoms, and subseq uently died of primary pneumonic plague. Public health officials shoul d be vigilant for plague activity in rodent populations, veterinarians should suspect feline plague in ill or deceased cats, and physicians should have a high index of suspicion for plague in any person who has traveled to plague enzootic areas.