Distinguishing Natural Disease vs Bioterrorism
- Recent endemic exposure by handling the carcasses of wild
animals, especially burrowing rodents, rabbits or hares, coyotes,
or other carnivores.
- Handling of a sick cat or history of flea bites in endemic
- Recent history of travel in an endemic plague area (western
United States, as well as international locations).
- Cases are sporadic, infrequent, and typically occur in the
rural endemic areas of the western United States.
- In the U.S., bubonic plague is the most common clinical presentation.