California Department of Public Health Investigates Human Plague Case

California Department of Public Health (CDPH) director and state health officer Dr. Karen Smith today announced the department is investigating a case of human plague in California, and conducting an environmental evaluation in the Stanislaus National Forest, Yosemite National Park and the surrounding areas.
The department began investigating this incident after a child from Los Angeles County became ill and was hospitalized after visiting the Stanislaus National Forest and camping at Crane Flat Campground in Yosemite National Park in mid-July. No other members of the camping party reported symptoms and health officials are continuing to monitor the child’s family and treatment providers. The child is recovering.

Plague is an infectious bacterial disease that is carried by squirrels, chipmunks and other wild rodents and their fleas. When an infected rodent becomes sick and dies, its fleas can carry the infection to other warm-blooded animals or humans.

“Human cases of plague are rare, with the last reported human infection in California occurring in 2006,” Smith says. “Although this is a rare disease, people should protect themselves from infection by avoiding any contact with wild rodents. Never feed squirrels, chipmunks, or other rodents in picnic or campground areas, and never touch sick or dead rodents. Protect your pets from fleas and keep them away from wild animals,” Smith adds.

CDPH is working closely with the Los Angeles County Department of Public Health (LACDPH), Centers for Disease Control and Prevention (CDC), Yosemite National Park and the U. S. Forest Service to investigate the source of the infection, and the patient’s travel history and activities during the incubation period. 

As a precaution, Yosemite National Park will provide additional information to visitors about steps to prevent plague exposure, and post caution signs at the Crane Flat campground and nearby campgrounds. Steps the public can take to avoid exposure to human plague include:

- Never feed squirrels, chipmunks or other rodents and never touch sick or dead rodents
- Avoid walking, hiking or camping near rodent burrows
- Wear long pants tucked into socks or boot tops to reduce exposure to fleas
- Spray insect repellent containing DEET on socks and pant cuffs to reduce exposure to fleas
- Keep wild rodents out of homes, trailers and outbuildings and away from pets.

Early symptoms of plague include high fever, chills, nausea, weakness and swollen lymph nodes in the neck, armpit or groin. People who develop these symptoms should seek immediate medical attention and notify their health care provider that they have been camping or out in the wilderness and have been exposed to rodents and fleas. Plague is treatable in its early stages with prompt diagnosis and proper antibiotic treatment. If not treated, plague can be fatal.

In California, plague-infected animals are most likely to be found in the foothills and mountains and to a lesser extent, along the coast. Desert and Central Valley areas are considered low risk for plague. State and local health officials regularly monitor plague-prone areas by testing animals and their fleas. In 2014, non-human plague activity was detected in animals in seven counties:  El Dorado, Mariposa, Modoc, Plumas, San Diego, Santa Barbara and Sierra.

Plague is not transmitted from human to human, unless a patient with plague also has a lung infection and is coughing. There have been no known cases of human-to-human infection in California since 1924. LACDPH and CDPH believe the risk of human-to-human transmission is similarly low in this case.

The last reported cases of human plague in California occurred in 2005 and 2006 in Mono, Los Angeles and Kern counties and all three patients survived following treatment with antibiotics. Since 1970, 42 human cases of plague have been confirmed in California, of which nine were fatal.

Source: California Department of Public Health