Correction to: Zoonotic Disease Exposure Risk and Rabies Vaccination Among Wildlife Professionals.

The original version of the article unfortunately contained a typo error in second author name in the author group. The author name was incorrectly published as "Jesse Grewal" and the correct name is "Jessie Grewal".

Zoonotic Disease Exposure Risk and Rabies Vaccination Among Wildlife Professionals.

More than 70% of zoonotic diseases are wildlife associated putting wildlife professionals at increased risk of occupational exposure. In 2008 and 2018, the Arizona Department of Health Services surveyed Arizona wildlife professionals from multiple agencies to assess the risk of disease exposure, rabies pre-exposure prophylaxis (PrEP) history, personal protective equipment (PPE) use, and zoonoses knowledge. In 2008, a 12-question survey was distributed at a state wildlife professional meeting using an anonymous email link. In 2018, a 20-question survey was distributed using an anonymous email link to wildlife agency employees. We received 164 and 81 complete responses in the 2008 and 2018 surveys, respectively. Bites from rabies reservoir or spillover species were higher in 2008 (42%) than in 2018 (16%). More respondents received PrEP in 2018 (53%) than in 2008 (45%). Among 43 respondents who performed necropsies or collected animal samples within the past 5 years (2014-2018), only 60% always wore latex or nitrile gloves, and 79% never wore a facemask. Respondents indicated lower awareness of certain zoonoses, including brucellosis (72%) and leptospirosis (60%). Results on zoonoses awareness and reasons for non-use of PPE highlighted targets for education to improve practices, including facilitation of PPE training to prevent future disease transmission.

Plague in a Pediatric Patient: Case Report and Use of Polymerase Chain Reaction as a Diagnostic Aid.

We report a case of bubonic plaque in a 7-year-old patient who presented with a core temperature of 107°F, seizures, vomiting, altered mental status, and septic shock. This case highlights the utility of polymerase chain reaction (PCR) as a diagnostic aid for rapid presumptive identification of Yersinia pestis as well as the importance of correlating PCR results with clinical data. We discuss the various manifestations of plague as they relate to infection control, postexposure prophylaxis, antimicrobial therapy, and treatment duration.

Elevated Lyme disease seroprevalence among dogs in a nonendemic county: harbinger or artifact?

Lyme disease, a tick-borne illness caused by Borrelia burgdorferi, infects humans and other species, including dogs. Canine seroprevalence has been suggested as a sentinel marker of human disease risk. A recent publication reported high canine seroprevalence (>5%) in Routt County, Colorado, an area where Lyme disease is generally considered nonendemic. We surveyed veterinarians in Routt County and discovered that 11 of 12 seropositive dogs (>90%) had a documented history of travel to or residence in a Lyme disease endemic area. These findings do not support the presence of an undocumented disease focus and reveal that despite its high sensitivity, there are limitations in the specificity and positive predictive value of elevated canine seroprevalence as a marker of human risk.

Francisella tularensis subsp. novicida isolated from a human in Arizona.

BACKGROUND: Francisella tularensis is the etiologic agent of tularemia and is classified as a select agent by the Centers for Disease Control and Prevention. Currently four known subspecies of F. tularensis that differ in virulence and geographical distribution are recognized:tularensis (type A), holarctica (type B), mediasiatica, and novicida. Because of the Select Agent status and differences in virulence and geographical location, the molecular analysis of any clinical case of tularemia is of particular interest. We analyzed an unusual Francisella clinical isolate from a human infection in Arizona using multiple DNA-based approaches. FINDINGS: We report that the isolate is F. tularensis subsp. novicida, a subspecies that is rarely isolated. CONCLUSION: The rarity of this novicida subspecies in clinical settings makes each case study important for our understanding of its role in disease and its genetic relationship with other F. tularensis subspecies.

Primary pneumonic plague contracted from a mountain lion carcass.

BACKGROUND: Primary pneumonic plague is a rare but often fatal form of Yersinia pestis infection that results from direct inhalation of bacteria and is potentially transmissible from person to person. We describe a case of primary pneumonic plague in a wildlife biologist who was found deceased in his residence 1 week after conducting a necropsy on a mountain lion. METHODS: To determine cause of death, a postmortem examination was conducted, and friends and colleagues were interviewed. Physical evidence was reviewed, including specimens from the mountain lion and the biologist's medical chart, camera, and computer. Human and animal tissues were submitted for testing. Persons in close contact (within 2 meters) to the biologist after he had developed symptoms were identified and offered chemoprophylaxis. RESULTS: The biologist conducted the necropsy in his garage without the use of personal protective equipment. Three days later, he developed fever and hemoptysis and died approximately 6 days after exposure. Gross examination showed consolidation and hemorrhagic fluid in the lungs; no buboes were noted. Plague was diagnosed presumptively by polymerase chain reaction and confirmed by culture. Tissues from the mountain lion tested positive for Y. pestis, and isolates from the biologist and mountain lion were indistinguishable by pulsed-field gel electrophoresis. Among 49 contacts who received chemoprophylaxis, none developed symptoms consistent with plague. CONCLUSIONS: The biologist likely acquired pneumonic plague through inhalation of aerosols generated during postmortem examination of an infected mountain lion. Enhanced awareness of zoonotic diseases and appropriate use of personal protective equipment are needed for biologists and others who handle wildlife.