Human plague in the United States.
To the Editor:— The Aug 5, 1962 issue ofThe Journalcarried a cover picture of a painting by Arnold Bocklin entitled "Plague" and an article entitled "Human Plague in the United States" by Caten and Kartman. This article and the caption next to the cover picture carry misleading statements which I would like to call to your attention. Discussing the distribution of wild-rodent plague in the United States, Caten and Kartman state, "The reason why plague does not extend beyond the 100th meridian is poorly understood." While it is true that all human cases associated with wild rodents for which adequate data are available have been acquired west of the 100th meridian, and this corresponds quite well to the known distribution of wild-rodent plague, as shown by Caten and Kartman, very limited surveys of wild rodents and fleas for plague have been conducted east of the 100th meridian. 1 Many investigators believe that wild-rodent plague does not extend into the eastern states, largely on the basis of the distribution of human cases associated with wild rodents. On the other hand, plague-infected wild rodents or their ectoparasites have been identified from over 130 counties in the western
Epidemiologic and clinical features of an outbreak of bubonic plague in New Mexico.
An outbreak of seven cases of bubonic plague in New Mexico was investigated. Clinical features were studied and correlated with field studies in an attmept to determine the source of infection in patients with indefinite histories of exposure. Most patients presented with fever, malaise, and an acute painful lymphadenitis (bubo). One death occurred in a patient with bubonic-septicemic plague complicated by meningitis due to Yersinia pestis. All patients lived in rural or semirural areas, and most had been in the general vicinity of their usual residence during the six days prior to onset of symptoms. The outbreak was associated with probable epizootics in rodents in two different areas of the state. One case was traced to direct hand contact with plague-infected rabbits. One patient developed insect bites after sleeping in the same bed with a flea-infested cat. Three of the other five patients had insect bites, presumably flea bites, but none of the five recalled contact with rodents or rabbits. Four of the five, however, had been in contact with dogs or cats that were later shown to have titers of antibody to Y. pestis. These findings provide further support for the hypothesis that contact with domestic dogs and cats may result in direct or indirect transmission of Y. pestis to humans.
The Milroy Lectures, 1924, ON THE PLAGUE *
It is obvious from these values that the present material, taken as a whole, is in respect of its mortality an extremely good sample of the general population of the United States, as indicated by the Original Registration States in 1910. The results of this study cannot, therefore, be discarded or criticized on any ground of abnormality of the material. 2. At every age from 30 to 100 inclusive the persons in the " all moderate " class of drinkers, whether males or females, have a somewhat higher expectation of life than the persons in the " abstainer " class of the same age. The two life curves are not widely different, but what advantage there is lies with the moderate drinkers. 3. Male persons in the " all heavy " class have a markedly loiver expectation of life at all ages from 30 to 100 inclusive thani male persons in the " all moderate " class; and a markedly loIcCi' expectation of life than persons in the " abstaiiiei " class up to and ilncluding age 60. From age. 60 on the expectatioii of life is somewhat, though not greatly, higher in the " all heavy " class than in the abstainer " class. This result may possibly be due to a 6elective effect of thle veryr high mortality in the heavy drinlking g;roup) prior' to age 60. In the case of the females the expectationl of life is mlarkedly loleci for thec personls in the "' all heavy " group than for persons in eithler the "abstainer " or the " all moderate" group, a#s5;all ages from 30 to 100 inclusive. 4. The "nmoderate steady " class, which is from certain points of view the most important one, shows consistently the highest expectation of life at all ages from 30 to 100 inclusive in the case of the females; and also in the males, except that after 70 the " all moderate " male gr,oup has very slightly higher expectations than the " moderate steady " male group. These conclusions are drawn from what is believed to be demonstrably the most critically adequate niiaterial, considering both quality and quantity, which has ever been available for the study of the problem of the influence of alcohol upon the duration of human life.