Nobody really wants to give mouth-to-mouth resuscitation to a plague victim.

But if you're a first responder in north-central New Mexico, it's a situation you might find yourself in.

Plague is pretty much always present in this part of the country, but this summer the disease has been especially pronounced, spreading through animal populations and infecting six people in New Mexico so far, including an 8-year-old Santa Fe County boy who died.

That boy and his 10-year-old sister, who also caught the bacterial disease but recovered, became sick in Edgewood, said the city's mayor, Robert Stearley.

And the circumstances around the case have him concerned, Stearley said.

"One or more of our fire personnel tried to revive the boy," Stearley said. "But afterward, there was no report back from the hospital that he died of plague. There was no information that they might have been exposed."

Stearley is concerned about how plague cases are reported to the public in New Mexico. He wants first responders to know exactly where cases are and to have more immediate notification from health officials so they will be warned if they've been exposed to the disease, he said.

But the Department of Health has a set of rules that prevent revealing the exact location of cases, and officials say if a case of the more rare contagious form of the plague occurs, that the department will quickly notify anybody who has been exposed.

"The only way you can get plague through respiratory droplets (or saliva) is if the person has pneumonic plague," said Deborah Busemeyer, a spokeswoman for the department. "That's a very rare form of the disease, and the first responders in the boy's case were not exposed to it. If it was pneumonic plague, we would have gone out and told everybody that was possibly exposed."

Pneumonic plague happens when normal bubonic plague spreads to the lungs and infects saliva. Bubonic plague, which causes pus-filled sacs called buboes to form, is the form most cases take. Advanced bubonic plague can turn into pneumonic plague if it gets to the lungs. But bubonic plague can't be spread by saliva, Busemeyer said.

Symptoms of both types of plague include a sudden onset of high fever, chills, muscle aches and extreme weakness. The disease is most commonly spread when fleas from an infected or dead animal bite an uninfected animal or person.

The Department of Health handles most of the reporting for plague cases in the state, and generally will only say what county a human plague case was in, due to rules it has to protect patient privacy.

The other four human cases it reported this summer were in a 54-year-old Santa Fe County man, an 83-year-old Sandoval County woman, and a 16-month-old female baby and her 67-year-old great-grandfather in the East Mountain area of Bernalillo County. All those patients have recovered.

Bernalillo County is the only area that reports its own cases to the public, because Albuquerque's Environmental Health Department, which handles investigations for both the city and county, has enough resources to monitor concerns in the region.

That department, which is combined with the Bernalillo County Environmental Health Office, also works with the Department of Health on plague cases, but it sometimes releases a bit more information about locations, usually at least saying if a case was in Albuquerque's East Mountains or in the city.

Santa Fe County has no environmental health department to handle plague cases, so, like other counties, it relies on information from the Health Department.

The Department of Health is unlikely to change its policy on releasing information by county, because besides patient privacy issues, officials also feel it's important to warn people in a broad area to be cautious when cases occur, said Paul Ettestad, the state public health veterinarian.

"We have plague in all areas of Santa Fe County, so we want people to pay attention," Ettestad said.

The department does give much more specific information about animal cases, which is listed on its Web site at www.health.state.nm.us/epi/plague.html.

"With animal cases, we like to give more specific information, while at the same time trying to emphasize safety concerns for a wide area," Ettestad said.

Stearley, however, believes the public and his first responders would be much better served if the department changed its policy and released more information, he said.

"They want to make sure people are alert so they don't release where cases are? I think that's a lame excuse," Stearley said. "I think we'd all be better served if we knew where those cases were. It's probably not in all places across the county equally."

Stearley and officials from the city of Albuquerque and the Bernalillo County Office of Environmental Health are planning a public meeting for the evening of Aug. 4 to discuss the disclosure issue further. Officials from Santa Fe County and the state Department of Health could also be invited, but the meeting is still in the early planning stages, said Lucas Tafoya, who is organizing the event in Tijeras.

The meeting will be open to everyone, so if Santa Fe County residents want to attend they will be welcome, Tafoya said, adding that interested parties can call the Bernalillo County Office of Environmental Health at 314-0310.

Whether the human reporting changes or not, watching the animal data is probably the best way to stay informed about where exactly the disease is most active, Ettestad said.

Most of the human cases this year were associated with indoor-outdoor pets that were not treated for fleas, got infected with plague and then slept in a bed with their owners, he added.

"We do want everybody to be cautious," Ettestad said. "If you look at the animal data, you'll see that plague is very widespread."

This year, in Taos, Rio Arriba, Santa Fe and San Miguel counties, there have been five confirmed cat cases and six confirmed dog cases. There have also been seven confirmed rabbit or rodent cases in Santa Fe and Mora counties.

It's also interesting to note that for the past two decades, Santa Fe County has had the most human cases in the state, which is another good reason to stay cautious, Ettestad said.

Santa Fe County had 11 cases between 1990 and 1999 and has had 11 cases from 2000 to mid-July 2009.

From 1949 to 2008, there have been 53 human cases in Santa Fe County — which has the highest number overall for those years. That is followed by McKinley County, which had 39 cases, and Bernalillo County, which had 35.

But while the disease used to be more prevalent in the northwest part of New Mexico, it has moved, possibly with rodent populations, closer to north-central New Mexico.

"We've noticed that trend of cases moving to the north-central part of the state, but I don't think anybody can tell you why that is," Ettestad said. "I personally think it gets in the animal population and it can just kind of smolder along."

That said, it's good advice for anybody in the area to just follow safety precautions, such as treating pets for fleas, avoiding contact with dead or sick rodents, and being aware of plague symptoms, Busemeyer added.

"It's still summer. June, July and August are generally the most active times of the year for plague," Busemeyer said. "We just want to make sure people know it's out there and know how to protect themselves."

Contact Sue Vorenberg at svorenberg@sfnewmexican.com.