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Pneumonic plague cluster, Uganda, 2004

Elizabeth M Begier1, Gershim Asiki, Zaccheus Anywaine

  • 1Centers for Disease Control and Prevention, Atlanta, Georgia, USA. ebegier@health.nyc.gov

Emerging Infectious Diseases
|May 18, 2006
PubMed

Insights

Pneumonic plague, a serious respiratory illness, is not as contagious as commonly believed. This study found person-to-person transmission occurred mainly via respiratory droplets, with a low attack rate among close contacts.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Public and clinical perception suggests pneumonic plague is highly contagious, leading to alarm during outbreaks.
  • Previous understanding of pneumonic plague transmission has been based on limited evidence.

Purpose of the Study:

  • To investigate the communicability of pneumonic plague in a real-world outbreak setting.
  • To determine the transmission routes and attack rate of pneumonic plague.

Main Methods:

  • Case definitions for probable and definite pneumonic plague were established.
  • Laboratory confirmation using direct fluorescent antibody microscopy and PCR on sputum samples.
  • Contact tracing and attack rate calculation among close contacts.

Main Results:

  • A cluster of 1 definite and 3 probable pneumonic plague cases was identified.
  • Two index patients each transmitted the infection to only one caregiver.
  • The overall attack rate among 23 close contacts was 8%.

Conclusions:

  • Pneumonic plague transmission is limited, primarily occurring through respiratory droplets.
  • The findings challenge the perception of high contagiousness and suggest a lower risk than previously assumed.

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