Volume 21, Number 1—January 2015
CME ACTIVITY - Synopsis
Epidemiology of Human Plague in the United States, 1900–2012
Kiersten J. Kugeler
, J. Erin Staples, Alison Hinckley, Kenneth L. Gage, and Paul S. Mead
, J. Erin Staples, Alison Hinckley, Kenneth L. Gage, and Paul S. Mead
Table 1
Epidemiologic characteristics of human plague, United States, 1900–2012*
| Characteristic | 1900–1925 | 1926–1964 | 1965–2012 | All years |
|---|---|---|---|---|
| No. cases | 496 | 42 | 468 | 1,006 |
| Median no. cases per year (range) | 3.5 (0–191) | 1 (0–5) | 8 (1–40) | 3 (0–191) |
| No. counties with reported case exposures | 18 | 32 | 113 | 135 |
| Years with no reported cases, % | 19 | 44 | 0 | 20 |
| Male sex | 341/483 (71) | 35/42 (83) | 268/467 (57) | 644/992 (65) |
| Median age, y (range) |
30 (<1–84) |
15 (3–67) |
28 (<1–94) |
29 (<1–94) |
| Race/ethnicity | ||||
| White | 224/409 (55) | 19/23 (83) | 198/370 (54) | 441/802 (55) |
| Asian | 127/409 (31) | 0/23 (0) | 3/370 (1) | 130/802 (16) |
| American Indian | 1/409 (<1) | 3/23 (13) | 123/370 (33) | 127/802 (16) |
| Hispanic | 46/409 (11) | 1/23 (4) | 46/370 (12) | 93/802 (12) |
| Black |
11/409 (3) |
0/23 |
0/370 |
11/802 (1) |
| Primary clinical form | ||||
| Bubonic | 344/415 (83) | 31/36 (86) | 369/462 (80) | 744/913 (82) |
| Pneumonic | 60/415 (15) | 3/36 (8) | 11/462 (2) | 74/913 (8) |
| Septicemic | 8/415 (2) | 2/36 (6) | 77/462 (17) | 87/913 (10) |
| Pharyngeal | 3/415 (<1) | 0/36 (0) | 3/462 (1) | 6/913 (1) |
| Gastrointestinal |
0/415 (0) |
0/36 (0) |
2/462 (<1) |
2/913 (<1) |
| Route of infection, no. (%)† | ||||
| Person-to-person | 49 (10) | 0 | 0 | 49 (5) |
| Known flea bite | 2 (<1) | 3 (7) | 101 (22) | 106 (11) |
| Animal butchering/skinning | 6 (1) | 8 (19) | 50 (11) | 64 (6) |
| Animal bite/scratch/cough | 2 (<1) | 0 | 19 (4) | 21 (2) |
| Animal handling | 0 (0) | 5 (12) | 86 (18) | 91 (9) |
| Unknown | 437 (88) | 26 (62) | 238 (51) | 701 (70) |
*Values are no. assessed/no. cases (%) except as indicated.
†During 1965–2012, a total of 26 case-patients had both known flea bite and animal contact.
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