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'Bioluminescent' Reporter Phage for the Detection of Category A Bacterial Pathogens
Published on: July 8, 2011
[The plague, possible bioterrorist act]
Philippe Bossi1, François Bricaire
1Service de maladies infectieuses et tropicales groupe hospitalier pitié-salpêtrière 47-83, Boulevard de l'hôpital, 75013 Paris-France. philippe.bossi@psl.ap-hop-paris.fr
Abstract:
PLAGUE AND BIOWARFARE: Plague is an infection caused by Yersinia pestis. This is a major agent that might be used as a biological weapon. If the bacteria is sprayed, the most frequent clinical form would be pneumonia. If contaminated fleas were used, the bubonic and septicaemic forms would be those observed. Suspicious context A biowarfare act by spraying Y pestis must be suspected when a patient without any risk factors presents with a primary pulmonary form of the disease in a non endemic area.
Practical Management:
All the patients presenting with a pulmonary form of plague must be hospitalised and isolated in de-pressurised room, at least for the first three days of antibiotherapy. For the other clinical forms, patients must isolated during the first 48 hours of treatment. Treatment must be initiated as rapidly as possible. Strains of Y. pestis are usually sensitive to many antibiotics (streptomycin, gentamicin, doxycycline, ciprofloxacin, chloramphenicol, sulfadiazin, trimethoprime-sulfamethoxazole...).
Prevention:
In the case of contact with a spray suspected of containing the plague bacilla, doxycycline or ciprofloxacin can be prescribed. A dead cell vaccine exists, but its efficacy in terms of protection from primary pneumonia appears inadequate.
Insights
Plague, caused by Yersinia pestis, can be a bioweapon. Early antibiotic treatment is crucial for pulmonary plague, while vaccines offer limited protection against this biological threat.
Area of Science:
- Microbiology and infectious diseases
- Biodefense and biowarfare preparedness
- Public health and epidemiology
Context:
- Yersinia pestis is a potential bioweapon agent.
- Plague can manifest as pneumonic, bubonic, or septicemic forms.
- Biowarfare involving Y. pestis spraying should be suspected in non-endemic areas with unexplained primary pneumonic plague.
Purpose:
- To outline the clinical presentation and diagnosis of plague, particularly in a biowarfare context.
- To detail the immediate management and treatment protocols for various plague manifestations.
- To discuss preventive measures, including antibiotic prophylaxis and vaccination.
Summary:
- Plague, caused by Yersinia pestis, presents differently based on transmission route (sprayed bacteria vs. flea bites).
- Pneumonic plague from spraying in non-endemic areas suggests biowarfare.
- Prompt hospitalization, isolation, and broad-spectrum antibiotics are critical for treatment.
- Antibiotics like doxycycline and ciprofloxacin are effective, but vaccine efficacy against pneumonic plague is limited.
Impact:
- Highlights the importance of recognizing plague as a potential bioweapon.
- Provides guidance for rapid clinical response and effective management of plague cases.
- Informs public health strategies for biodefense and disease prevention.
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