title: [Primary pneumonic plague with nosocomial transmission in La Libertad, Peru 2010].
abstract: Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person.
  
  
  OBJECTIVE
  To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru.
  
  
  METHODS
  The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed.
  
  
  RESULTS
  The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50% (2/4).
  
  
  CONCLUSIONS
  Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.
authors.affiliation: Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú.
authors.forename: Luis F
authors.initials: LF
authors.lastname: Donaires
authors.forename: Manuel
authors.initials: M
authors.lastname: Céspedes
authors.forename: Pedro
authors.initials: P
authors.lastname: Valencia
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Salas
authors.forename: María E
authors.initials: ME
authors.lastname: Luna
authors.forename: Alex
authors.initials: A
authors.lastname: Castañeda
authors.forename: Víctor
authors.initials: V
authors.lastname: Peralta
authors.forename: César
authors.initials: C
authors.lastname: Cabezas
authors.forename: Paul E
authors.initials: PE
authors.lastname: Pachas
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D010930:Plague / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult