Lessons Learned about Pneumonic Plague Diagnosis from 2 Outbreaks, Democratic Republic of the Congo
Shako, Jean Christophe
Kone, Mamadou Lamine
AffiliationWorld Health Organization, Geneva, Switzerland; Centre de Recherche du Service de Sante des Armees, Grenoble, France; Plague Reference Laboratory, Bunia, Democratic Republic of the Congo; National Institutes of Health, Bethesda, Maryland, USA; World Health Organization, Brazzaville, Republic of Congo; National Health Laboratory Service, Johannesburg, South Africa; Bundeswehr Institute of Microbiology, Munich, Germany; Institut National de la Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo; World Health Organization, Kinshasa; Medecins Sans Frontiere, Bruxelles, Belgium; Medecins sans Frontieres, Geneva; Institut Pasteur, Antananarivo, Madagascar
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JournalEmerging Infectious Diseases
AbstractPneumonic 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.
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