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1/9. Cases of cat-associated human plague in the Western US, 1977-1998.

    Exposure to cats infected with yersinia pestis is a recently recognized risk for human plague in the US. Twenty-three cases of cat-associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat-associated human plague did not increase significantly during summer months. plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat-associated human plague than at exposure sites for other cases. The risk of cat-associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment.
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2/9. Rabies surveillance in the united states during 2000.

    During 2000, 49 states, the district of columbia, and puerto rico reported 7,364 cases of rabies in nonhuman animals and 5 cases in human beings to the Centers for disease Control and Prevention, an increase of 4.3% from 7,067 cases in nonhuman animals reported in 1999. Ninety-three percent (6,855 cases) were in wild animals, whereas 6.9% (509 cases) were in domestic species (compared wth 91.5% in wild animals and 8.5% in domestic species in 1999). Compared with cases reported in 1999, the number of cases reported in 2000 increased among bats, dogs, foxes, skunks, and sheep/goats and decreased among cats, cattle, horses/mules, raccoons, and swine. The relative contributions of the major groups of animals were as follows: raccoons (37.7%; 2,778 cases), skunks (30.2%; 2,223), bats (16.8%; 1,240), foxes (6.2%; 453), cats (3.4%; 249), dogs (1.6%; 114), and cattle (1.1%; 83). Ten of the 19 states where the raccoon-associated variant of the rabies virus has been enzootic reported increases in the numbers of cases of rabies during 2000. Among those states that have engaged in extensive wildlife rabies control programs, no cases of rabies associated with the epizootic of rabies in raccoons (or in any other terrestrial species) were reported in ohio, compared with 6 cases reported in 1999. No rabies cases associated with the dog/coyote variant (compared with 10 cases in 1999, including 5 in dogs) were reported in texas, and cases associated with the gray fox variant of the virus decreased (58 cases in 2000, including 38 among foxes). Reports of rabid skunks exceeded those of rabid raccoons in massachusetts and rhode island, states with enzootic raccoon rabies, for the fourth consecutive year. Nationally, the number of rabies cases in skunks increased by 7.1% from that reported in 1999. The greatest numerical increase in rabid skunks (550 cases in 2000, compared with 192 in 1999) was reported in texas. The number of cases of rabies reported in bats (1,240) during 2000 increased 25.4% over the number reported during 1999 (989) and represented the greatest contribution (16.8% of the total number of rabid animals) ever recorded for this group of mammals. Cases of rabies reported in cattle (83) and cats (249) decreased by 38.5% and 10.4%, respectively, whereas cases in dogs (114) increased by 2.7% over those reported in 1999. Reported cases of rabies among horses and mules declined 20% from 65 cases in 1999 to 52 cases in 2000. Four indigenously acquired cases of rabies reported in human beings were caused by variants of the rabies virus associated with bats. One case of human rabies acquired outside the united states that resulted from a dog bite was caused by the canine variant of the rabies virus.
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3/9. Cat bite transmission of yersinia pestis infection to man.

    The transmission of bubonic plague from the kitten of a domestic cat to a man by means of a bite on a finger is described. The human case was complicated by the development of a secondary meningitis, followed, after specific therapy, by protracted recovery. The kitten showed swollen lymph nodes of the head and neck, frothing at the mouth and nostrils, and signs of an acute infectious disease which had a fatal termination. yersinia pestis was isolated on about the 8th day from the cerebrospinal fluid of the man. The foster mother of the kitten exhibited signs of spinal and cerebral meningitis but recovered following treatment; her serum contained plague antibody levels of 1:512 and 1:1024 on the 22nd and 34th days respectively after the first evidence of illness. Three litter mates of the kitten also died. The outbreak occurred on a farm in the Graaff-Reinet district of the eastern Cape Province, which is situated about 160 km from the nearest known natural plague focus.
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4/9. Feline orthopoxvirus infection transmitted from cat to human.

    We report the case of a 56-year-old female patient who presented with an inflamed, ulcerated lesion on the left side of her neck after contact (scratch) with a cat living in the patient's house. Satellite lesions developed despite local treatment and parenteral clindamycin. Histopatholgic examination and the Tzanck test showed evidence of a viral infection. Subsequent transmission electron microscopy of scrap tissue and material from a fresh pustule exhibited multiple typical poxvirus particles, predominantly in remnants of scaled-off layers of degenerated keratinocytes, and virus particles in intermingled phagocytes, leading to the diagnosis of feline orthopoxvirus (cowpox virus) infection. These results were verified by polymerase chain reaction and sequencing. Concern has been raised as to whether discontinuation of smallpox vaccine would cause an increase in orthopoxvirus infection, but this has not yet shown to be the case.
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5/9. Primary conjunctival sporotrichosis: two cases from a zoonotic epidemic in Rio de Janeiro, brazil.

    PURPOSE: To describe sporothrix schenckii conjunctivitis in 2 owners of cats with sporotrichosis. methods: Small case series and literature review. RESULTS: Two women had been caring for their pet cats with sporotrichosis for 2 months but did not recall any traumatic injury such as scratches or bites. Each presented a conjunctival granulomatous lesion measuring 4 to 5 mm accompanied by local hyperemia, secretion, and edema, in addition to painful facial subcutaneous nodes and regional lymph node enlargement. Pyogenic material was collected from the conjunctival sac and from cutaneous lesions on the cats. In both the patients and their respective cats, fungal colonies were isolated and identified as S. schenckii. Treatment with oral itraconazole 100 mg/d for 3 months resulted in complete healing of lesions in both patients. patients remained clinically cured 15 months after end of treatment. CONCLUSION: sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.
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6/9. Cat-transmitted fatal pneumonic plague in a person who traveled from colorado to arizona.

    plague, primarily a disease of rodents and their infected fleas, is fatal in 50% of infected humans if untreated. In the united states, human cases have been concentrated in the southwest. The most common modes of plague transmission are through flea bites or through contact with infected blood or tissues; however, primary pneumonic plague acquired from cats has become increasingly recognized. We report on the case investigation of a patient, presumably exposed to a plague-infected cat in colorado, who presented with gastrointestinal symptoms, and subsequently died of primary pneumonic plague. public health officials should be vigilant for plague activity in rodent populations, veterinarians should suspect feline plague in ill or deceased cats, and physicians should have a high index of suspicion for plague in any person who has traveled to plague enzootic areas.
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7/9. Bats, cats, and rabies in an urban community.

    Bats are the primary vectors of rabies in humans in the united states. In the urban environment they generally are found within buildings where they may bite people or be attacked by cats or dogs. Given the high probability that any bat that bites a person may be rabid, antirabies prophylaxis should be administered as soon as possible after the incident. This should not be delayed pending laboratory results on the bat. Children should be taught to avoid contact with moribund bats. cats are more likely to be involved with rabid bats than dogs, but they are less likely to be vaccinated against rabies. The occasional rabid cat in an urban community may have acquired its infection from a bat. Therefore, it is vital that communities enforce rabies vaccination for cats as well as dogs.
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8/9. tularemia from a cat bite: case report and review of feline-associated tularemia.

    We report the case of a 63-year-old man who developed ulceroglandular tularemia complicated by pneumonia following a cat bite. A review of the literature revealed 51 cases of cat-related tularemia reported since 1928. Details of 15 cases (including the present case) were available and analyzed. If, following feline contact, patients develop pneumonia or if patients with skin and soft-tissue infection fail to respond to therapy with penicillin, physicians should be alerted to the possibility of tularemia. A greater awareness of this complication following a cat bite or cat scratch is important for recognizing this uncommon infection.
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9/9. adult toxocara cati infections in U.S. children: report of four cases.

    We report four cases of passage of subadult or adult toxocara cati worms by young children ages 20 months to seven years. Worms were expelled rectally in two cases and in two cases they were vomited. A single worm was passed in two cases, three worms in one case, and 15 worms in the fourth case. All worms that were available for study were identified as T. cati by morphologic criteria, including the arrow-shaped cervical alae and the digitiform shape of the male tail. None of the four children exhibited clinical signs of ocular or visceral larva migrans, and in two cases where serum samples were available, neither child had a titer to toxocara. These results further the argument that these children acquired the worms through the ingestion of immature worms passed by infected cats, not through the ingestion of infective eggs. Although the children were generally not ill as a result of these unusual infections, it does serve to reinforce the public health issue that potential serious consequences can occur where children have exposure to an environment that has been contaminated with cat feces, or, more specifically, infective eggs, and could become infected with larval forms of toxocara.
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