Pneumonic plague cluster, Uganda, 2004
Pneumonic plague cluster, Uganda, 2004
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DOI：
10.3201/eid1203.051051
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发表时间：
2006-03-01
影响因子：
11.8
通讯作者：
Kool, JL
中科院分区：
文献类型：
--
作者：
Begier, EM;Asiki, G;Kool, JL
公众和临床医生长期以来一直认为肺鼠疫具有高度传染性;在疫情爆发期间发生了不适当的警报和恐慌。我们调查了自然发生的肺鼠疫集群的传染性。我们将一例疑似肺鼠疫病例定义为2004年12月在乌干达Kango县发生的急性呼吸道疾病伴血痰。确诊病例是一个很可能的病例，具有鼠疫耶尔森氏菌感染的实验室证据。该集群（1例确诊病例和3例很可能病例）由2对并发索引患者-护理人员对组成。对唯一幸存患者的痰液进行直接荧光抗体显微镜检查和聚合酶链反应检测证实了鼠疫感染。两名指示患者均仅将肺鼠疫传播给1名护理人员，尽管另有23名未经治疗的密切接触者（发病率8%）。人与人之间的传播与呼吸道飞沫而不是气溶胶的传播是相容的，只有少数密切接触者（都在飞沫范围内）患病。
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.