Primary pneumonic plague contracted from a mountain lion carcass.
BACKGROUND
Primary pneumonic plague is a rare but often fatal form of Yersinia pestis infection that results from direct inhalation of bacteria and is potentially transmissible from person to person. We describe a case of primary pneumonic plague in a wildlife biologist who was found deceased in his residence 1 week after conducting a necropsy on a mountain lion.


METHODS
To determine cause of death, a postmortem examination was conducted, and friends and colleagues were interviewed. Physical evidence was reviewed, including specimens from the mountain lion and the biologist's medical chart, camera, and computer. Human and animal tissues were submitted for testing. Persons in close contact (within 2 meters) to the biologist after he had developed symptoms were identified and offered chemoprophylaxis.


RESULTS
The biologist conducted the necropsy in his garage without the use of personal protective equipment. Three days later, he developed fever and hemoptysis and died approximately 6 days after exposure. Gross examination showed consolidation and hemorrhagic fluid in the lungs; no buboes were noted. Plague was diagnosed presumptively by polymerase chain reaction and confirmed by culture. Tissues from the mountain lion tested positive for Y. pestis, and isolates from the biologist and mountain lion were indistinguishable by pulsed-field gel electrophoresis. Among 49 contacts who received chemoprophylaxis, none developed symptoms consistent with plague.


CONCLUSIONS
The biologist likely acquired pneumonic plague through inhalation of aerosols generated during postmortem examination of an infected mountain lion. Enhanced awareness of zoonotic diseases and appropriate use of personal protective equipment are needed for biologists and others who handle wildlife.
Wong
David
D
Office of Public Health, National Park Service, Albuquerque, New Mexico, USA. david_wong@nps.gov
Wild
Margaret A
MA
Walburger
Matthew A
MA
Higgins
Charles L
CL
Callahan
Michael
M
Czarnecki
Lawrence A
LA
Lawaczeck
Elisabeth W
EW
Levy
Craig E
CE
Patterson
J Gage
JG
Sunenshine
Rebecca
R
Adem
Patricia
P
Paddock
Christopher D
CD
Zaki
Sherif R
SR
Petersen
Jeannine M
JM
Schriefer
Martin E
ME
Eisen
Rebecca J
RJ
Gage
Kenneth L
KL
Griffith
Kevin S
KS
Weber
Ingrid B
IB
Spraker
Terry R
TR
Mead
Paul S
PS
D000328:Adult; D000818:Animals; D015373:Bacterial Typing Techniques; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D005334:Fever / Q000209:etiology; D005838:Genotype; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000473:pathology; D017720:Molecular Epidemiology; D016273:Occupational Exposure; D010930:Plague / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D046011:Puma / Q000382:microbiology*; D015010:Yersinia pestis / Q000302:isolation & purification*