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Last Updated

07 Nov 2002

Source: New York Times, November 7, 2002.

New Mexico Man, 53, Is Seriously Ill With Plague at Beth Israel


A 53-year-old New Mexico man was in critical condition last night at Beth Israel Medical Center with bubonic plague, the rare and deadly disease that once decimated Europe, health officials said.

His wife, a 47-year-old woman, remains under observation at Beth Israel as tests for the disease are conducted.

Despite the rarity of the disease -- health officials said they could not recall another confirmed case in New York City -- experts said last night that the man had almost certainly contracted the illness in Santa Fe, N.M., one of the only places in the nation where bubonic plague occurs with any regularity.

The officials dismissed any suggestion that criminal activity, including bioterrorism, might have been involved.

In a statement, Beth Israel said the couple, whose names were not released, had traveled to Manhattan from "a rural area of New Mexico." They arrived at the emergency room on Tuesday night "after several days of flulike symptoms, high fevers and swollen lymph nodes," the statement said.

"Taking all of the necessary precautions, the patients were immediately placed in isolation, and the hospital immediately notified the New York City Department of Health," it said.

The woman was in stable condition at Beth Israel last night. The man was on a respirator.

At a news conference last night, Thomas R. Frieden, the city's health commissioner, said that both victims were residents of the Santa Fe area who had arrived in New York City on a vacation on Nov. 1. He said that they became ill on Sunday. The timing provided evidence that the man, and perhaps the woman, became infected before arriving in the city, since the incubation period before symptoms of plague become apparent is two to seven days.

Dr. Frieden said that New York City health officials had been in contact with the medical authorities in New Mexico, and had obtained more evidence that the infection most likely occurred in that state.

The New Mexico officials found evidence in July that a dead wood rat on property owned by the couple now confined to Beth Israel had been carrying fleas infected by the bubonic plague, he said.

"We are confident the exposure occurred in New Mexico," Dr. Frieden said. "There is no risk to New Yorkers from the individuals who are being evaluated for plague."

One government health official said last night that the chances that anyone else had been infected with the plague by either victim was remote. The official said the disease, which can be treated with antibiotics if diagnosed quickly, can be transmitted from person to person only through direct contact with a draining skin lesion. The most recent case of person-to-person infection in the Unites States was in 1925, the official said.

"We hear the words 'bubonic plague' and think about the horrible things that happened in Europe, but they didn't have antibiotics then," the official said. "This is not a public health threat, not a situation where anybody else needs to be concerned."

In the 14th century, 25 million deaths in Europe were attributed to bubonic and pneumonic plague, known collectively as the Black Death.

City health officials, citing data from the Centers for Disease Control, said there are 10 to 15 cases of plague annually across the nation, mostly in rural areas of New Mexico, Colorado, Arizona, California, Oregon and Nevada. Other records show that there are 10 to 40 cases each year, about half of them in Santa Fe County, said the government health official, who declined to be identified.

The disease is transmitted by fleas that attach themselves to wild animals. The official said the high concentration of infections near Santa Fe apparently results from a large population of rodents.