Although several states in the western United L States are considered to be endemic for plague, human infections with Pasteurella pestis are infrequent in this country. Many American physicians, however, will practice in areas of the world where plague is not only endemic but frequently epidemic. For example, over 3,500 cases of plague were reported in South Vietnam during 1967, and approximately 1,000 cases were reported in the Saigon-ChoLon area during the early part of 1968. Although likely to be infrequent, there is the possibility that physicians within the United States may see an occasional returning serviceman with plague.
The problem of epidemic plague was recently reported in the Archives of Internal Medicine by Conrad et al,1 who discussed an epidemic which occurred in Cam Ranh City, South Vietnam in March 1967, involving 57 Vietnamese and one American soldier. Four of six patients with pneumonic plague died, but none