Bichat guidelines for the clinical management of plague and bioterrorism-related plague.
Yersinia pestis appears to be a good candidate agent for a bioterrorist attack. The use of an aerosolised form of this agent could cause an explosive outbreak of primary plague pneumonia. The bacteria could be used also to infect the rodent population and then spread to humans. Most of the therapeutic guidelines suggest using gentamicin or streptomycin as first line therapy with ciprofloxacin as optional treatment. Persons who come in contact with patients with pneumonic plague should receive antibiotic prophylaxis with doxycycline or ciprofloxacin for 7 days. Prevention of human-to-human transmission via patients with plague pneumonia can be achieved by implementing standard isolation procedures until at least 4 days of antibiotic treatment have been administered. For the other clinical types of the disease, patients should be isolated for the first 48 hours after the initiation of treatment.
Bossi
Philippe
P
Task Force on Biological and Chemical Agent Threats, Public Health Directorate, European Commission, Luxembourg. philippe.bossi@psl.ap-hop-paris.fr
Tegnell
Anders
A
Baka
Agoritsa
A
Van Loock
Frank
F
Hendriks
Jan
J
Werner
Albrecht
A
Maidhof
Heinrich
H
Gouvras
Georgios
G
D023482:Bioterrorism / Q000517:prevention & control* / Q000706:statistics & numerical data; D003140:Communicable Disease Control / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D005060:Europe; D005062:European Union; D006801:Humans; D010930:Plague / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods*