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Plague (Yersinia pestis)
1996 Case Definition
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:
- Regional lymphadenitis (bubonic plague)
- Septicemia without an evident bubo (septicemic
plague)
- Plague pneumonia, resulting from hematogenous
spread in bubonic or septicemic cases (secondary pneumonic
plague) or inhalation of infectious droplets (primary pneumonic
plague)
- Pharyngitis and cervical lymphadenitis resulting
from exposure to larger infectious droplets or ingestion of
infected tissues (pharyngeal plague)
Laboratory criteria for diagnosis
Presumptive
- 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
- Detection of F1 antigen in a clinical specimen
by fluorescent assay
Confirmatory
- Isolation of Y. pestis from a clinical
specimen or
- 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
See also:
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