title: Pneumonic plague cluster, Uganda, 2004.
abstract: 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.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. ebegier@health.nyc.gov
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Begier
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.forename: Zaccheus
authors.initials: Z
authors.lastname: Anywaine
authors.forename: Brook
authors.initials: B
authors.lastname: Yockey
authors.forename: Martin E
authors.initials: ME
authors.lastname: Schriefer
authors.forename: Philliam
authors.initials: P
authors.lastname: Aleti
authors.forename: Asaph
authors.initials: A
authors.lastname: Ogden-Odoi
authors.forename: J Erin
authors.initials: JE
authors.lastname: Staples
authors.forename: Christopher
authors.initials: C
authors.lastname: Sexton
authors.forename: Scott W
authors.initials: SW
authors.lastname: Bearden
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Kool
mesh_terms: D000328:Adult; D016358:Contact Tracing; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D010930:Plague / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000635:transmission*; D011159:Population Surveillance; D014454:Uganda / Q000453:epidemiology