The Case of the Coughing Cat sounds like a Perry Mason mystery from the 1930s. But it's real, not fictional, and it's now, not then.
The cat was coughing because it had the fearsome disease, plague. It may have sprayed droplets of its bacteria-laden saliva on a Santa Fe county family. If so, they were in mortal danger. When the sick cat was finally taken in January to a veterinarian, the disease was suspected, and a test by the New Mexico Department of Health confirmed it.
Plague comes in three versions: Bubonic strikes the lymph nodes in the groin, armpit or neck, and they become swollen and painful. Septicemia means the bacteria go directly into the blood, causing high fever, abdominal pain and diarrhea. Pneumonic invades the lungs; it is the least common and most perilous. That's what the cat had. "If pneumonic plague is not recognized in humans, and they're not given the proper antibiotics within 18 hours of the onset of symptoms," says Dr. Paul Ettestad, New Mexico Public Health Veterinarian, "then mortality goes over 90 per cent."
Eight people, members of the family, the vet and an assistant, were immediately put on the antibiotic doxycycline for seven days as prophylaxis. Luckily, they never developed the disease. The cat died.
The incident confirmed New Mexico's reputation as the plague capital of America, with more than half of all the cases and deaths in the country. The state began tracking plague in 1949. Since then, as of early March, 256 humans have been infected with the disease and 33 of them have died. (Worldwide cases of plague range from 1,000 to 3,000 annually).
Most of the New Mexico cases have been in the northern part of the state. In fact, Santa Fe County has more cases than any other area; one reason is the spread of homes out into the remote and rodent-filled desert. But in January, Eddy County in the south reported its first-ever case. It involved a 50-year-old hunter who shot and skinned an infected rabbit and either got blood or tissue into a cut in his hand or was bitten by an infected flea on the animal. The hunter was hospitalized with bubonic plague, given massive doses of streptomycin, then recovered at home.
Now, dear reader, before you panic, sell your house and flee New Mexico, be assured that your chance of contracting plague is infinitesimal. But it makes sense to understand the disease and how to protect yourself.
It is an ancient affliction, dating back 15 centuries. There have been three known global pandemics, or widespread, lengthy epidemics. The first was in 540 AD. It moved from East Africa to the Mediterranean Sea, lasted half a century and claimed 40 million lives, or about 15 per cent of the world's population then.
The second pandemic occurred in the 1500s and became known as the Black Death (for the ghastly color a victim's skin turned when the disease destroyed tiny blood vessels). It began in Asia and spread to Europe on trading ships, eventually killing from a fourth to a third of that continent's population, or 25 million people.
The third or modern pandemic began in the late 19th century in China, and was carried on ships to San Francisco and other west coast ports. The death toll was far lower, but it introduced the disease to the continental United States, and plague in New Mexico, first discovered in 1938, is traceable to that outbreak. At about that time, the bacteria that causes the disease was identified, and its transmission by fleas, long suspected, was confirmed.
The fleas came ashore on rats, the disease over time spread to wild rodents along the Pacific coast and those infected animals moved inexorably east, decade after decade. Plague has so far reached the 100th meridian in the U.S., or the western Dakotas, according to Veterinarian Paul Ettestad.
A plague scare rocked New York City in 2002 when a Santa Fe couple checked into a Manhattan hotel and quickly became sick. Taken to a hospital, both were discovered to have bubonic plague. The wife soon recovered, but the husband nearly died and eventually had to have both legs amputated below the knee because of capillary damage, or Black Death. Their plight made headlines in New York newspapers, the year after 9/11, not least because of the fear of possible bioterrorist attack with plague bacteria.
But why does New Mexico have more plague than anywhere else? Nobody is sure. Dr. Ettestad has a theory. "It may be due to the diversity of rodents here, lots of different kinds of rodents and lots of different kinds of fleas. The disease just smolders along, going from rodent to rodent and flea to flea." It is especially prevalent among rock squirrels, prairie dogs and wood rats. Inhabiting these animals are more than 100 species of fleas; 33 of them are plague-infected. The climate and vegetation here in the high desert also are particularly nurturing. (Only a few parts of the world don't have plague; Australia, curiously, is one of them).
"The years when we have more human cases correlate with moisture," Dr. Ettestad explains. "When we have more rainfall and more rodent food, their population goes up. They fight for territory and are more likely to spread the disease to one another and to interact with people."
For Santa Feans, here are a few precautionary measures to take, especially now that warm weather is returning: