Pneumonic plague is no stranger to L.A. -- we’ve had our own epidemic

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With China moving to control an outbreak of pneumonic plague, it’s worth noting that the disease doesn’t occur only in places for which Americans need a passport to visit. In fact, Los Angeles has dubious bragging rights to the United States’ most recent rat-borne epidemic.

Here’s a review of that epidemic from the Yale Journal of Biology and Medicine.

The recap begins: ‘On October 29, 1924, a physician requested an ambulance from the Los Angeles
County General Hospital for Two Mexican patients critically ill of a malady which he could not definitely diagnose, but which he knew to be highly contagious since several others in the neighborhood were also affected with similar symptoms of very high fever and pains in the back and chest. The following day 13 other cases displaying the same symptoms were detected and subsequently admitted to the hospital,
where they all developed signs of severe pneumonia, with bloody expectoration and marked cyanosis.’

For information on the plague in general, check out the plague home page from the Centers for Disease Control and Prevention. (It’s fascinating stuff.) If you’re pressed for time, there’s also a more succinct fact sheet -- and some details about California’s and the West’s brushes with the disease and how the forms of the disease differ. (Of note: Ground squirrels are not your friend. Please stop trying to make them eat from your hand.)

A highlight from the fact sheet: ‘About 14% (1 in 7) of all plague cases in the United States are fatal. Most cases in the U.S. receive some antibiotic treatment during their course of illness and deaths typically result from delays in seeking treatment or misdiagnosis. Reportedly, about 50-60% of bubonic plague patients who fail to receive any antibiotic treatment die. Untreated septicemic or pneumonic plague is almost always fatal.’

Sounds dramatic, doesn’t it? Of course, 14% of U.S. cases is still a very, very small number -- the disease is reported in only about five to 15 people each year.

Here’s a look at some of the more recent cases in the United States. (About 90% of the 362 cases from 1944 through 1993 were in Arizona, California, Colorado and New Mexico.)

In general the plague is spread by rats and rodents. Well, fleas on the rats and rodents. Even more specifically, the bacterium Yersinia pestis, which is carried by those fleas. This is the same culprit responsible for the bubonic form of plague that ravaged Europe in the 1300s. Then, it was known as the Black Death. Here’s an account from writer Giovanni Boccaccio, who was in Florence at the time.

In the current China outbreak, the bacterium is causing the lung-focused pneumonic form, which is less common than the bubonic form but more lethal. The disease can also be picked up by inhaling respiratory droplets from an infected person or animal. (Those how-to-sneeze-and-cough lessons in the current swine flu outbreak would serve you well; and, given the choice of droplet-borne diseases, take swine flu.)

This column on the plague, from the Los Angeles Times, sums up the disease’s current status in the United States: Now it’s more of a fluke than a plague

And here’s today’s L.A. Times story, which prompted this digression: Pneumonic plague reported in remote western China

-- Tami Dennis