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1924 Los Angeles pneumonic plague outbreak
The 1924 Los Angeles pneumonic plague outbreak began October 30, 1924, and was declared fully contained on November 13, 1924. It represented the first time plague had emerged in Southern California. Previously, plague outbreaks had arisen in San Francisco and nearby Oakland marking the first time plague had emerged in California. The Los Angeles outbreak began on October 30th, lasted two weeks, and killed 30 people. Public health officials credited the lessons learned from the San Francisco outbreak coupled with swiftly implemented measures, including hospitalization of the sick and all their contacts, a neighborhood quarantine, and a large-scale rat eradication program, with saving lives.〔A.J. Viseltear. The Pneumonic Plague Epidemic of 1924 in Los Angeles. Yale J. Biol. Med. 1974 March; 47 (1): 40-54.〕〔Jacob L. Kool. Risk of Person to Person Transmission of Pneumonic Plague. Clin. Infect. Dis. (2005) 40 (8): 1166-1172.〕〔Martin Helen Eastman, The History of Los Angeles County Hospital, 1878–1968; and the Los Angeles County University of Southern California Medical Center 1969–1978. (Los Angeles: University of Southern California Press, 1979) 5–7.〕
== Epidemiology ==
Traceback analysis to identify the index-patient revealed that the outbreak actually began sometime in late September or early October, 1924 when a 51-year-old man named Jesús Lujan, living in the Macy Street district near downtown Los Angeles, fell ill with fever and a painful lump in his groin. Prior to symptoms, Lujan had discovered a decaying rat under his house and picked it up and threw it in the trash. Within that same week, Lujan's fifteen-year-old daughter, Francisca (Concha), also fell ill. She complained of fever and respiratory distress. A physician called to the house diagnosed the daughter with 'double pneumonia' and diagnosed Lujan's enlarged lymph node as being associated with a venereal disease. 〔〔Cecilia Rasmussen "Los Angeles Then and Now," March 5, 2006, The Los Angeles Times.〕 Investigators believed that Jesús Lujan initially contracted the bubonic form of plague. Left untreated, bubonic plague can move to the lungs and cause a secondary pneumonic infection.〔Jacob L. Kool. Risk of Person-to-Person Transmission of Pneumonic Plague. Clin Infect Dis. (2005) 40 (8): 1166-1172.〕 As Lujan's end-stage symptoms included bloody sputum, it's believed his had converted to the pneumonic form. And because he fell ill before any of the others, Jesús Lujan was identified as the index-patient.
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