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 Bioterrorism  Holistic-online.com

Plague

Clinical description

Plague is transmitted to humans by fleas or by direct exposure to infected tissues or respiratory droplets; the disease is characterized by fever, chills, headache, malaise, prostration, and leukocytosis that manifests in one or more of the following principal clinical forms:
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Regional lymphadenitis (bubonic plague)

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Septicemia without an evident bubo (septicemic plague)

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Plague pneumonia, resulting from hematogenous spread in bubonic or septicemic cases (secondary pneumonic plague) or inhalation of infectious droplets (primary pneumonic plague)

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Pharyngitis and cervical lymphadenitis resulting from exposure to larger infectious droplets or ingestion of infected tissues (pharyngeal plague)

Laboratory criteria for diagnosis

Presumptive

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Elevated serum antibody titer(s) to Yersinia pestis fraction 1 (F1) antigen (without documented fourfold or greater change) in a patient with no history of plague vaccination or

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Detection of F1 antigen in a clinical specimen by fluorescent assay

Confirmatory
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Isolation of Y. pestis from a clinical specimen or

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Fourfold or greater change in serum antibody titer to Y. pestis F1 antigen

Case classification

Suspected: a clinically compatible case without presumptive or confirmatory laboratory results

Probable: a clinically compatible case with presumptive laboratory results

Confirmed: a clinically compatible case with confirmatory laboratory results

Source: Centers for Disease Control, USA

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