Plague surveillance report ; no. 2, July 1971
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    During 1970, human plague was detected in 13 persons from three western states. All but one survived the infection, although two were not diagnosed until after the acute phase of their illness. The single fatality (case 13, Table 1) did not seek medical help until the fifth day of illness, six hours before he expired. One of the two persons who survived without a specific diagnosis (case 10, Table 1) had received specific antibiotic therapy for plague with a clinical diagnosis of tularemia. The other (case 4) received only penicillin and recovered without benefit of specifically effective antimicrobial therapy. Both of these cases were detected retrospectively by screening suspect tularemia cases for evidence of serum antibodies to Yersinia pestis and are discussed in detail below.

    The 1970 plague cases constitute the largest annual number of reported human infections contracted from wild animal sources, as well as the largest number of human cases since the urban rat-borne epidemics prior to 1925. The past year concludes a decade of unprecedented numbers of human infections in the United States (Figure 1). Human plague cases by decade beginning in 1931 numbered 11, 11,9, and 41; fatalities in these four decades were 5 (45 percent), 6 (55 percent), 4 (44 percent), and 8 (20 percent), respectively. Figure 1 also reveals that, whereas 80 percent of human cases were reported from the Pacific States from 1925 to 1950, the Mountain States have accounted for 90 percent of human infections in the past two decades. California and New Mexico have reported the majority of cases.

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    I. Introduction -- II. Surveillance -- III. Research investigations and techniques -- IV. Plague Seminar, Fort Collins, Colorado, October 5-7, 1970 -- V. International notes -- Tables & figures.
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