A pediatric critical care doctor's quick, outside-the-box thinking saved
the life of a 7-year-old girl who'd contracted a rare case of bubonic
plague while camping in southwest Colorado.
Sierra Jane Downing had come upon a half-eaten squirrel while on a
picnic with her family on Aug.19 in Pagosa Springs. A passionate animal
lover, the young girl asked her parents if she could bury the animal.
Her mother said no.
"We told her to stay away from it, but when she went down to the creek
to play with her 13-year-old sister, Sierra Jane went back to the
squirrel, put her sweatshirt down next to it, and then picked up the
sweatshirt and put it around her waist," her mother, Darcy Downing, told
ABC News.
Five days later, Sierra Jane woke up with a fever and was vomiting, and
by 9 p.m. her father found her lying on the bathroom floor. When he
picked her up to bring her back to bed, the girl threw up again and then
had a seizure.
At that point the girl's dad knew something was very wrong, and he
rushed her to the local hospital near their Pagosa Springs home.
Sierra Jane's clear chest X-ray and only slightly elevated white blood
cell count offered local doctors no clue that Sierra Jane had contracted
the disease that wiped out one-third of Europe's population in the 14th
century.
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While the doctors called around to other Colorado hospitals, they
managed to bring Sierra Jane's temperature down from 107 to 103 degrees.
After speaking with doctors at the Rocky Mountain Hospital for Children
in Denver, they had Sierra Jane flown there. When she arrived at 5 a.m.
the next day she still very sick but stable, so doctors placed her in
the hospital's intermediate care unit under continuous monitoring.
By 6:30 p.m. Saturday, Sierra Jane's condition had worsened and she was transferred to pediatric ICU for septic shock.
"It was touch-and-go for a while, and all we could do is pray," her father, Sean Downing said.
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Doctors initially thought that Sierra Jane's altered mental state --
which included delirium and hallucinations -- was a result of a dose of
the antibiotic ceftriaxone.
Dr. Jennifer Snow, the pediatric critical care specialist whose quick
thinking proved so important, ran some blood tests on Sierra Jane, as
the girl was in disseminated intravascular coagulopathy, meaning her
blood would not clot. Snow then reinterviewed the family about where
Sierra Jane had been and what she might have been exposed to.
"Mom told us the story of the exposure to the dead squirrel, and
exposure to mouse droppings in chicken coops, and exposure to a dead
skunk," Snow told ABC News.
By then Snow was getting an inkling of what Sierra Jane might have
contracted. Snow did an immediate literature search, and found a report
of a 16-year-old with fulminant septic shock in the chest whose cause
of death was listed as bubonic plague.
Snow promptly contacted Dr. Wendi Drummond, a pediatric infectious
disease specialist, who recommended starting the girl on gentamicin, an
antibiotic used to treat many types of bacterial infections.
Sierra Jane completed her course of antibiotics on Wednesday and could
be going home by the end of the week, according to Drummond.
This is the first case of bubonic plague that either Snow or Drummond
had seen in their careers. In Colorado, the disease, that had killed an
estimated 25 million Europeans more than 500 years ago and was once
called the Black Death, had not been seen since 2006.
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