An Oregon man who contracted a rare case of the plague trying to take a mouse from the jaws of a choking cat is no longer in a critical condition, and has talked about his fears of losing all of his fingers as a result of the disease.
The family of Paul Gaylord, a welder from Prineville in rural Oregon, released pictures showing his hands withered by the cell-killing infection and darkened to the colour of charcoal.
"I don't think I can do my job," he told the Associated Press in a phone interview from hospital.
"I'm going to lose all my fingers on both hands. I don't know about my thumbs. The toes – I might lose all them, too."
He faces a difficult recovery now that he is no longer in intensive care, and his family is trying to raise money to get him into a new house, because the manufactured home he was living in has a leaky roof, a mouldy bathroom and mice – dangerous living conditions for someone with a weakened immune system.
"We didn't even know the plague was around anymore," said his sister, Diana Gaylord. "We thought that was an ancient, ancient disease."
The disease, which rampaged through Europe in the middle ages and is thought to have wiped out between a quarter and a third of the population, is caused by the Yersinia pestis bacterium. It can develop into three kinds of plague including the bubonic plague, which swells lymph nodes across the body. The other two are septicaemic plague, which affects the bloodstream, and pneumonic plague, which affects the lungs.
Gaylord's illness began after he saw a stray cat with a dead mouse jammed in the back of his throat. The cat appeared to be choking, so Gaylord and a friend attempted to dislodge the mouse. The distressed cat bit his hand. Unable to remove the mouse, Gaylord shot Charlie to end his suffering and buried him in the yard. Two days later, he awoke with a fever and chills.
He spent nearly a month on life support and only recently left the intensive care unit. At one point, doctors thought he was going to die, said Debbie Gaylord, his wife.
A hospital chaplain baptised the unconscious patient and Gaylord's son, Jake, arrived from Austin, Texas, to say goodbye. Hours later, doctors told his family that he had improved.
The cat's body was dug up, and tests confirmed it had the plague. Other cats and dogs in the area were tested and none had the disease.