Pneumonic plague cluster, Uganda, 2004

Pneumonic plague cluster, Uganda, 2004

The public and clinicians have long-held beliefs that pneumonic plague is highly contagious; inappropriate alarm and panic have occurred during outbreaks. We investigated communicability in a naturally occurring pneumonic plague cluster. We defined a probable pneumonic plague case as an acute-onset...

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Bibliographic Details
Published in:Emerging infectious diseases Vol. 12; no. 3; pp. 460 - 467
Main Authors: Begier, Elizabeth M, Asiki, Gershim, Anywaine, Zaccheus, Yockey, Brook, Schriefer, Martin E, Aleti, Philliam, Ogden-Odoi, Asaph, Staples, J Erin, Sexton, Christopher, Bearden, Scott W, Kool, Jacob L
Format: Journal Article
Language:English
Published: United States U.S. National Center for Infectious Diseases 01-03-2006
Centers for Disease Control and Prevention
Subjects:
2004 AD
Adult
Contact Tracing
Development and progression
Disease Outbreaks
Epidemics
Female
Humans
Male
Plague
Plague - diagnosis
Plague - epidemiology
Plague - pathology
Plague - transmission
pneumonia
Population Surveillance
Uganda
Uganda - epidemiology
Yersinia pestis
Uganda
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Summary:The public and clinicians have long-held beliefs that pneumonic plague is highly contagious; inappropriate alarm and panic have occurred during outbreaks. We investigated communicability in a naturally occurring pneumonic plague cluster. We defined a probable pneumonic plague case as an acute-onset respiratory illness with bloody sputum during December 2004 in Kango Subcounty, Uganda. A definite case was a probable case with laboratory evidence of Yersinia pestis infection. The cluster (1 definite and 3 probable cases) consisted of 2 concurrent index patient-caregiver pairs. Direct fluorescent antibody microscopy and polymerase chain reaction testing on the only surviving patient's sputum verified plague infection. Both index patients transmitted pneumonic plague to only 1 caregiver each, despite 23 additional untreated close contacts (attack rate 8%). Person-to-person transmission was compatible with transmission by respiratory droplets, rather than aerosols, and only a few close contacts, all within droplet range, became ill.
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ISSN:1080-6040
1080-6059
DOI:10.3201/eid1203.051051