Plague may be transmitted from cats to people by which routes?

• A. Cat bites
• B. Flea bites
• C. Aerosol transmission
• D. All of the above

Answer: (D)

Plague transmission from cats to people can occur through several routes because infected cats can connect the flea-rodent cycle to humans in multiple ways. Fleas that bite an infected cat can pick up Yersinia pestis and then transmit it to a person with a subsequent bite. Direct contact with an infected cat—through bites, scratches, or handling tissues or fluids from an infected animal—can inoculate the bacteria into the skin. If a cat has pneumonic plague or carries respiratory secretions, coughing can release infectious droplets that another person can inhale. Because all of these pathways are possible, the infection can be transmitted by all of the listed routes.