Primary Pneumonic Plague Contracted from a Mountain Lion Carcass

被引:46
作者
Wong, David [1 ]
Wild, Margaret A.
Walburger, Matthew A. [2 ]
Higgins, Charles L. [7 ]
Callahan, Michael [3 ]
Czarnecki, Lawrence A. [3 ]
Lawaczeck, Elisabeth W. [4 ]
Levy, Craig E. [4 ]
Patterson, J. Gage [4 ]
Sunenshine, Rebecca [4 ,8 ]
Adem, Patricia [9 ]
Paddock, Christopher D. [9 ]
Zaki, Sherif R. [9 ]
Petersen, Jeannine M. [5 ]
Schriefer, Martin E. [5 ]
Eisen, Rebecca J. [5 ]
Gage, Kenneth L. [5 ]
Griffith, Kevin S. [5 ]
Weber, Ingrid B. [5 ]
Spraker, Terry R. [6 ]
Mead, Paul S. [5 ]
机构
[1] Natl Pk Serv, Off Publ Hlth, Albuquerque, NM USA
[2] Natl Pk Serv, Off Publ Hlth, Flagstaff, AZ USA
[3] Coconino Cty Hlth Dept, Flagstaff, AZ USA
[4] Arizona Dept Hlth Serv, Phoenix, AZ 85007 USA
[5] Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Ft Collins, CO USA
[6] Colorado State Univ, Vet Diagnost Lab, Ft Collins, CO 80523 USA
[7] Natl Pk Serv, Off Publ Hlth, Washington, DC 20240 USA
[8] Ctr Dis Control & Prevent, Coordinating Off Terrorism Preparedness & Emergen, Atlanta, GA USA
[9] Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Atlanta, GA USA
关键词
YERSINIA-PESTIS; BUBONIC PLAGUE; EXPOSURE; CATS; TRANSMISSION;
D O I
10.1086/600818
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Primary pneumonic plague is a rare but often fatal form of Yersinia pestis infection that results from direct inhalation of bacteria and is potentially transmissible from person to person. We describe a case of primary pneumonic plague in a wildlife biologist who was found deceased in his residence 1 week after conducting a necropsy on a mountain lion. Methods. To determine cause of death, a postmortem examination was conducted, and friends and colleagues were interviewed. Physical evidence was reviewed, including specimens from the mountain lion and the biologist's medical chart, camera, and computer. Human and animal tissues were submitted for testing. Persons in close contact (within 2 meters) to the biologist after he had developed symptoms were identified and offered chemoprophylaxis. Results. The biologist conducted the necropsy in his garage without the use of personal protective equipment. Three days later, he developed fever and hemoptysis and died similar to 6 days after exposure. Gross examination showed consolidation and hemorrhagic fluid in the lungs; no buboes were noted. Plague was diagnosed presumptively by polymerase chain reaction and confirmed by culture. Tissues from the mountain lion tested positive for Y. pestis, and isolates from the biologist and mountain lion were indistinguishable by pulsed-field gel electrophoresis. Among 49 contacts who received chemoprophylaxis, none developed symptoms consistent with plague. Conclusions. The biologist likely acquired pneumonic plague through inhalation of aerosols generated during postmortem examination of an infected mountain lion. Enhanced awareness of zoonotic diseases and appropriate use of personal protective equipment are needed for biologists and others who handle wildlife.
引用
收藏
页码:E33 / E38
页数:6
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