Cindy Roper says surviving the plague has made her appreciate life more.
'Tomorrow is not guaranteed,' she says. 'I'm going to live now.'
By BEN SWAN | The New Mexican August 18, 2007
Cerrillos resident Cindy Roper survives bout with deadly disease persistent in Northern New Mexico
It was the headache that finally forced Cindy Roper to call an ambulance. The upset stomach and the nausea could be controlled, along with the fluctuating temperature.
But the headache would not ease its grip.
``Nothing I took would get rid of my headache,'' the Cerrillos resident said. ``That's the thing that alerted me, and I think that's what saved me. I'm a wimp. I thought, `I've got to get rid of this headache; take me to the hospital.' ''
Roper's illness initially stumped the doctors. A spinal tap, a computed tomography scan, magnetic resonance imaging and chest X-rays ruled out spinal meningitis and a host of other diseases. More than a week later, with a regime of antibiotics in her system, Roper convinced the hospital staff she was well enough to go home.
A few days later, an infectious diseases specialist confirmed what had been a growing suspicion: Roper had contracted the plague. She became another statistic, the fourth confirmed human plague case this year in New Mexico, a place that racks up more than half the nation's cases every year.
She was lucky. A 3-year-old Bernalillo County boy died of bubonic plague the same day she became sick. And in 2002, Eldorado resident John Tull lost both his legs because of complications brought on by plague.
``I'm part of an exclusive club,'' Roper said. ``When you hear the word plague, you think you're going to die, or you're going to be really, really sick for a very long time, or something horrific is going to happen to you. But that's not (always) the case if you're aware it's out there, and you recognize the symptoms and get treated right away.''
Plague sources
No one knows precisely why plague remains persistent in Northern New Mexico, said Dr. Paul Ettestad, the state Health Department's public health veterinarian. One theory is that the mix of juniper and pi�ons in the region helps maintain a high diversity among rodent populations. That diversity allows plague, a bacterial disease of rodents, to survive through what Health Department officials call susceptible and maintenance animals.
Maintenance animals, such as deer mice, are resistant to plague. The bacteria spread to susceptible animals, such as prairie dogs, rock squirrels and wood rats, through infected flea bites. The bacteria kill those animals rather rapidly, Ettestad said, but the hungry fleas then search for other blood hosts, such as humans and their pets.
Most people contract plague through infected flea bites, but there are other ways, according to the Health Department. Some people have contracted the disease through direct contact with an infected animal's blood or tissue while skinning game, and others have become infected by inhaling infectious respiratory droplets expelled by a person or cat with pneumonic plague.
There are three forms of plague. Bubonic strikes the lymph nodes in the groin, armpit or neck, which become swollen and painful. Symptoms generally develop within two or three days of contact with an infected animal or flea bite and include high fever, chills, weakness, headache and muscle ache.
Septicemic plague, which Roper contracted, occurs when the bacteria go directly into the blood: There are no swollen lymph nodes, just fever and severe flulike symptoms.
If the bacteria invade the lungs, then pneumonic plague might develop, and the disease can spread to other people through coughs and sneezes.
Risk factors
Summer is generally the prime time for plague, said Deborah Busemeyer, a spokeswoman with the state Health Department. That's mainly because the weather is warmer, and people and their pets are out and can come in contact with the rodent population.
The four plague cases this year were likely caused by flea bites, possibly through pets bringing fleas back to their owners, Ettestad said. Dogs and cats often roam or hunt around rodents and inadvertently pick up fleas. That's why Ettestad and the Health Department stress keeping animals leashed while out walking, using effective flea treatment and not allowing animals to sleep on your bed.
Most healthy dogs can survive a bout of plague, but the disease can be fatal to cats, Ettestad said. Plague symptoms in cats are similar to humans: Fever, lethargy, lack of appetite and swollen lymph nodes. Prompt diagnosis and antibiotic treatment greatly reduces the fatality rate among pets and humans.
Making your home less welcoming to rodents is another critical step in reducing the risk of contracting plague, Ettestad said.
``People can do simple things to reduce risk,'' he said. ``Avoid sick and dead animals; don't let pets out to roam or hunt; keep children away from burrows; reduce rodent attractants such as birdseed -- don't put it on the ground or close to the house; don't leave food or water for your cat or dog outside.''
Curious children are especially prone to contracting plague, Busemeyer said. ``We want parents to urge children not to play around rodent nests or in or near burrows,'' she said.
A medical mystery
Roper lives on an idyllic 10 acres of land near Cerrillos. Her two dogs have the run of the tidy acreage that sustains a garden, flower beds and fruit trees. Paths wind through the property that take her to outbuildings and a well-used clothes line.
She often walks by a bush where she suspects a rock squirrel had built its burrow, but has since abandoned it. She said she's unsure where she contracted plague, something that hounds her as it does many plague victims.
Roper has found support with Tull and his wife, Lucinda Marker, the Eldorado couple who contracted plague in 2002. The two had flown to New York City when they came down with the symptoms and were diagnosed with bubonic plague. Marker recovered quickly, but Tull was given a slim chance for survival.
As Tull's organs began to shut down, doctors induced a coma to give his body time to rest. Tull survived, but had to have both legs amputated below the knee. The two have rebuilt their lives and have written a book on their ordeal.
Tull and Marker likely contracted plague while out on a hike with their dogs. While Roper has two dogs, she said she's never seen a flea on her dogs, in her house or on her property. She doesn't recall ever being bit by a flea.
But a flea bite is likely the source of her sudden battle with plague, health officials said.
The day Roper became sick, Memorial Day, was a typical morning. A friend walked over, and the two sat on her back patio for a chat and coffee. Roper had planned to ride two horses that morning and then attend a neighborhood party that evening.
``I started feeling really, really tired,'' she said. ``I thought, `OK, I need to go back to bed for an hour or so.' ''
But once in bed, Roper developed the shakes and suffered from an upset stomach and nausea. She realized entertaining was out of the question, so she decided to ride out what she thought was a bout of food poisoning.
Ginger ale and charcoal tablets helped clear out her stomach, but her temperature kept rising and the headache increased in pressure. Over the next few days, Roper said she took aspirin, Aleve and Tylenol in an attempt to keep her temperature down and get rid of the headache.
On the third day, she forced herself to drive to Santa Fe to work, but after a few hours, Roper decided she needed medical help. At an urgent care center, she was tested for influenza, mononucleosis and strep throat, and was rehydrated with two bags of liquid.
``When I got home, I was feeling a lot better, and I thought I could go to work,'' she said. ``So the next day, I got up and my headache was still there and my temperature was 103. So I thought, whatever this is, it's not going away. I called the ambulance.''
Paramedics arrived first and took her vitals. Her temperature had risen to 104 degrees. In the ambulance, she became violently ill.
At the hospital, Roper endured a series of tests to pinpoint her illness. Blood cultures were taken, and doctors began to wonder what was going on, she said. But there weren't any obvious symptoms of plague, such as sores or swollen lymph nodes.
She was admitted to the hospital and given intravenous therapy of antibiotics and pain medication for her headache. ``It was a godsend,'' she said.
Four days later, the antibiotics had kicked in and her headache was gone. But there was still no diagnosis. By this time, Roper had also been tested for West Nile and Lyme disease and had another MRI.
An infectious diseases specialist, Dr. Mary Ellen Lawrence, was brought in for consultation. After six days in the hospital, Lawrence told her an anaerobic culture -- one of the four blood cultures taken -- had started to grow something plaguelike.
``It didn't frighten me,'' Roper said. ``I knew that I was going to be OK at that point because I was already feeling better. Whatever it was had been kicked out.''
Two days later, Roper was allowed to return home with more antibiotics. Two days after that, Lawrence called Roper's house.
``A soon as I knew she was trying to get ahold of me, I knew something was up,'' Roper said. ``In my mind, I still wasn't 100 percent sure I had the plague. But then when I did talk to her, that's what she said: I was positive for plague.''
The diagnosis made Roper unsure of herself: Was she contagious? Should she be doing anything differently? But Lawrence eased her worried mind.
``She said, `No, don't cancel any plans. Just keep on going with your life,' '' Roper recalled. `` `But the Health Department will be contacting you.' ''
Pinpointing plague
The following Tuesday, three people from the Health Department were at Roper's door. They set between 75 and 100 traps, she said, and swabbed burrows for fleas. They also applied insecticide and pointed out problem areas on the property: birdseed on the ground, rock walls, abandoned outbuildings. The specimens were sent to labs for testing.
The traps collected 13 animals -- 12 rodents and a sick baby rabbit, Roper said. Several dead animals also were found on the property, but few fleas.
Ettestad, the state veterinarian, said site visits are essential once plague has been confirmed. He was part of the crew that inspected Roper's property.
``The primary objective is to find immediate risk,'' he said. ``There have been cases were we've found infected wood rats in or near the house.''
Tests results from the Centers for Disease Control and Prevention recently confirmed a plague-positive specimen from the bone of a dried-up dead wood rat, Roper said. Health officials told her other tests from live rodents were negative as were tests on the fleas found in the burrows and on the animals.
It's not unusual to have negative specimens from live rodents, health officials told Roper. Positive specimens are most likely from dead rodents in the area or fleas from burrows. But based on the positive test and the investigators observations, health officials said Roper's property was the most likely site of exposure.
Roper said health officials speculate the rock squirrel living in a burrow under a bush likely died from the plague. Infected fleas either jumped on Roper while she was working in the yard or traveled to her through one of her dogs.
``She had a lot of birdseed all around on the ground,'' Ettestad said. ``There was no evidence of rodent traffic 100 feet from her house, but closer to the house, we saw lots of evidence of deer mice and other host animals.''
Another of the Health Department's objectives is education. The department spent time going door to door, talking with neighbors about the risk of plague and handing out pamphlets on preventing rodents from nesting close to homes.
Lessons learned
Health officials are bound by confidentiality issues. There's a certain amount of stigma associated with plague, but Ettestad said he hopes people and doctors report the occurrence to the department.
Roper said she's familiar with the disease's stigma but mainly from people who are uninformed. Her neighbors were supportive once they learned the cause of her illness.
``Not one person (in the neighborhood) treated me like I had the plague,'' Roper said. ``They were all concerned about whether or not I was well. But I cannot say that about everyone (elsewhere). Some made me feel so dirty.''
Roper said she does understand some of their concerns. News reports never address exactly where plague was found, which makes some people feel as if they are immune. And the toddler who died of bubonic plague reportedly lived in horrible conditions.
``I want people to understand you do not have to live in filth in order to get the plague,'' Roper said. ``You can have a very clean lifestyle and a very healthy lifestyle and still be susceptible. No matter where you live, you have to be aware of it and take precautions.''
These days, Roper is as healthy as ever, although she said she sometimes tires easily. She said she's working on changing rodent-welcome areas on the property and is cautious about where she walks.
Health officials say plague is enzootic in New Mexico, meaning it's established in the rodent and flea population. It might wax and wane and seem to disappear for a while, but a long-term study in Eldorado indicates the plague simmers in an area and never really goes away.
Surviving the plague has given Roper immunity for up to a year, doctors have told her. But the illness has taught her not to take life for granted.
``I'm a fairly healthy person, a self-sufficient adult woman who hasn't gotten side-whacked by something like this before,'' she said. ``So my philosophy has changed somewhat. I'm aware of how precious life is, and how precious good health is.
``Tomorrow is not guaranteed. I'm going to live now.''
Avoid contact with wild rodents and their fleas, nests and burrows. Prevent pets from hunting. Treat outdoor pets with flea control products regularly. Wear rubber gloves when handling game. Eliminate rodent shelter around the home: Stack woodpiles at least 12 inches above the ground and 100 feet from the house; Keep animal feed in rodent-proof containers; Get rid of junk piles and abandoned vehicles around the home; Report sick or dead rodents and rabbits. New Mexico Department of Health -------------------------------------------------------------------------------- PLAGUE FACTS
THE DISEASE:
Plague infects animals and humans and is caused by the bacterial germ Yersinia pestis. It is a rare, severe, life-threatening disease. About half of all cases of human plague in the United States occur in New Mexico. The three forms of plague include bubonic, septicemic and pneumonic.
CASES:
The number of cases varies yearly, ranging from 0 to 27 cases per year.
From 1983 through 2006, there were 135 human plague cases in New Mexico, averaging about six cases per year.
Since 1993, the number of cases has dropped to an average of less than four cases per year.
CAUSES:
People usually get plague by being bitten by an infected rodent; handling sick or dead animals infected withplague; being exposed to respiratory droplets from a person or cat with plague pneumonia. (This is extremely rare and has not happened in New Mexico.)
SYMPTOMS:
Plague symptoms occur between two and seven days after infection.
The most common signs are: sudden onset of high fever; muscle aches and headache; chills; extreme weakness. In 75 percent of the cases, lymph glands in the groin area, under the armor in the neck become extremely painful, tender and swollen.
TREATMENT:
Plague is curable with antibiotics, but medication must be started right away to avoid serious complications. Of the 250 human plague cases reported in New Mexico, 32 were fatal.
CARRIER ANIMALS:
Rodents are the main type of animal that carry plague.
Rodents include: squirrels, prairie dogs, wood rats, chipmunks and mice. Rabbits can also carry plague.
Rock squirrels and their fleas are the primary source of human plague cases in New Mexico. Wild and domestic carnivores, including dogs, cats, coyotes and bobcats can become infected with plague, probably by eating infected rodents or rabbits.
SEASONS:
The majority of New Mexico plague cases occur in the warmer months, from May until September.
New Mexico Department of Health
Click here for copyright permissions! Copyright 2007 The New Mexican, Inc.
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
| IP: Logged |
map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
I've always heard the saying "avoid like the plague", but couldn't of told you what the plague is. Interesting, thanks for posting.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6478 | From Louisville, Ky | Registered: Jan 2002
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
![[bonk]](graemlins/bonk.gif)
Printer-friendly view of this topic