title: Lessons learned about pneumonic plague diagnosis from two outbreaks, Democratic Republic of the Congo.
abstract: Pneumonic plague is a highly transmissible infectious disease for which fatality rates can be high if untreated; it is considered extremely lethal. Without prompt diagnosis and treatment, disease management can be problematic. In the Democratic Republic of the Congo, 2 outbreaks of pneumonic plague occurred during 2005 and 2006. In 2005, because of limitations in laboratory capabilities, etiology was confirmed only through retrospective serologic studies. This prompted modifications in diagnostic strategies, resulting in isolation of Yersinia pestis during the second outbreak. Results from these outbreaks demonstrate the utility of a rapid diagnostic test detecting F1 antigen for initial diagnosis and public health management, as well as the need for specialized sampling kits and trained personnel for quality specimen collection and appropriate specimen handling and preservation for plague confirmation and Y. pestis isolation. Efficient frontline management and a streamlined diagnostic strategy are essential for confirming plague, especially in remote areas.
authors.affiliation: World Health Organization, Geneva, Switzerland. bertherate@who.int
authors.forename: Eric
authors.initials: E
authors.lastname: Bertherat
authors.forename: Philippe
authors.initials: P
authors.lastname: Thullier
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Shako
authors.forename: Kathleen
authors.initials: K
authors.lastname: England
authors.forename: Mamadou Lamine
authors.initials: ML
authors.lastname: Koné
authors.forename: Lorraine
authors.initials: L
authors.lastname: Arntzen
authors.forename: Herbert
authors.initials: H
authors.lastname: Tomaso
authors.forename: Louis
authors.initials: L
authors.lastname: Koyange
authors.forename: Pierre
authors.initials: P
authors.lastname: Formenty
authors.forename: Florent
authors.initials: F
authors.lastname: Ekwanzala
authors.forename: Rosa
authors.initials: R
authors.lastname: Crestani
authors.forename: Isa
authors.initials: I
authors.lastname: Ciglenecki
authors.forename: Lila
authors.initials: L
authors.lastname: Rahalison
mesh_terms: D019411:Clinical Laboratory Techniques; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004196:Disease Outbreaks; D006801:Humans; D008297:Male; D010930:Plague / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D013048:Specimen Handling; D015010:Yersinia pestis / Q000472:pathogenicity; D055815:Young Adult