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Colorado girl beats the plague — with Utah medical grad's help

Published September 6, 2012 3:37 pm

Emergency • Sierra Jane Downing apparently got the disease from flea bites during a picnic.
This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Denver • Let no one say Sierra Jane Downing has not earned her Girl Scout badge for bubonic plague.

If the 107-degree fever didn't clinch it, then a flight rescue and two weeks in the hospital or being named the only Colorado plague case in six years certainly would.

Sierra Jane, 7, is recovering at Denver's Rocky Mountain Hospital for Children at Presbyterian/St. Luke's, after apparently picking up the plague from flea bites on a picnic near Pagosa Springs, Colo. She had been pondering the fate of a half-eaten squirrel carcass, asking her parents for a proper burial, when the fleas jumped onto a sweat shirt and bit her.

The Downing family outing morphed into a nightmarish medical mystery. Five days after their picnic, Sierra Jane woke up with a high fever. By that night, she was having seizures and temperature spikes in a Pagosa Springs emergency room.

The doctor, sensing the girl's life was in danger, phoned hospitals around the state for expertise on the odd combination of symptoms.

Jennifer Snow, a pediatric critical care physician on call at Rocky Mountain Children's, urged the girl's transport to Denver. Then she started hitting the books.

Septic shock. Seizures. Deathly high temperature. Swollen lymph nodes in the thigh. And then the story of Sierra Jane's encounter with the dead squirrel.

Snow, who graduated from the University of Utah Medical School, said she went to an online database of medical journals and, within two minutes, had her "aha" moment from a periodical called Chest.

Teenager, same symptoms = bubonic plague.

Snow consulted with colleagues and ordered a switch to an antibiotic known to attack the plague. They also called the Centers for Disease Control and Prevention, which happens to have plague experts in Colorado.

Although the disease hits only five to seven humans a year nationwide and is highly treatable, the doctors were worried. Even with the right antibiotic, Sierra Jane might get worse before she got better.

Darcy Downing, Sierra Jane's mom, said she was grateful, rather than terrified, at word of the "plague."

"Good, we're getting an answer," Downing said. "Plague can be fought."

Sierra Jane began to recover, and nearly two weeks after her flight for life, she may be released in a few days. She has taken short walks and sits upright in a wheelchair, but looks exhausted, and is annoyed at the two IV lines chafing her neck.

Local, state and federal officials consulted about new plague warnings for the San Juan area but did not find an unusual animal die-off or other concerns. They posted reminders at the campground about avoiding animals and wearing bug spray, but a tiny, background level of plague in wild animals is a Colorado fact.

Darcy and Sierra Jane want to put together a Girl Scout unit on diseases in the wilderness, and how to handle animal encounters — alive or dead.

Sierra Jane should make a full recovery.

In the meantime, the Downings are grateful for the Pagosa Springs doctor who sounded the alarm and the neighbors who helped take care of their house while they've been gone.

"If you ever want to see what it's supposed to be like in a small town, look at Pagosa Springs," Darcy Downing said. She said an infection is rampant there: "It's love."