A 70-year-old woman whose horse was ill with strangles contracted the disease, reports researchers from the University of Washington School of Medicine.
In horses, strangles is highly transmissible, but it is very rare that the disease is transmitted to humans. Transmission to humans may be caused when the person is exposed to secretions that contain a large amount of pathogens.
The woman presented to the emergency department with nausea, dry heaves, fever, chills, and shakes. She also had a significant cough, but no shortness of breath. She had no recent illness or immune-compromising medical conditions, and she took no prescription medications.
Cracking sounds could be heard in her lungs and a CT scan showed patchy, ground-glass opacities that might indicate partial lung collapse or an atypical infection. She was admitted to the hospital and IV antibiotics were begun. The woman had early sepsis and pneumonia.
One day after admission and beginning treatment, her blood pressure, heart rate, respiration rate, and temperature were back within normal ranges.
A PCR test on the woman's blood showed that she was positive for Streptococcus and she was advised to remain in the hospital. Six days before admittance to the hospital, the woman had found her horse looking ill and having trouble breathing. It died the next day, with blood and mucus coming from its mouth and nose. She held the horse as he died.
Researchers said this was the most likely cause of the horse-to-human transmission of the disease, though this cannot be absolutely confirmed.
Two days after admission, the woman was discharged while on amoxicillin and remained symptom free during her recovery.
There are only five Streptococcus equi subspecies equi infection cases in humans that have been reported worldwide. This case is the only horse-to-human case in the United States in the last 40 years.
The scientists note that individuals who are immunocompromised, who have cardiovascular disease, or who have a neurologic susceptibility are at higher risk of contracting the disease. Penicillin appears to be the proper treatment for S. equi infections in horses and humans.
Medical intervention is necessary to prevent an S. equi infection from causing significant issues in humans, like meningitis, bacteremia, or death, they conclude.
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