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Plague

Case Definition

Confirmed Case

Clinical illness and laboratory confirmation of infection: isolation of Yersinia pestis from body fluids

    OR
  • a significant (e.g. fourfold or greater) rise in serum antibody titre to Y. pestis fraction 1 (F1) antigen by EIA or passive hemagglutination / inhibition titre
  • OR
  • positive for specific bacteriophage lysis AND demonstration of Y. pestis F1 antigen by immunofluorescence
  • OR
  • positive for specific bacteriophage lysis AND detection of Y. pestis nucleic acid
  • OR
  • >1/10 passive hemagglutination / inhibition titre in a single serum sample in a patient with no history of vaccination or previous infection AND demonstration of Y. pestis F1 antigen by immunofluorescence
  • OR
  • detection of Y. pestis antibody by EIA AND demonstration of Y. pestis F1 antigen by immunofluorescence
  • OR
  • >1/10 passive hemagglutination / inhibition titre in a single serum sample in a patient with no history of vaccination or previous infection AND positive for specific bacteriophage lysis
  • OR
  • detection of Y. pestis antibody by EIA AND positive for specific bacteriophage lysis

Probable Case

Clinical illness with one of the following laboratory confirmations of infection: demonstration of elevated serum antibody titre(s) to Y. pestis F1 antigen (without documented 4-significant [e.g. fourfold or greater] change) in a patient with no history of plague immunization

    OR
  • demonstration of Y. pestis F1 antigen by immunofluorescence
  • OR
  • detection of Y. pestis nucleic acid
  • OR
  • >1/10 passive hemagglutination / inhibition titre in a single serum sample in a patient with no history of vaccination or previous infection
  • OR
  • detection of Y. pestis antibody by EIA
  • OR
  • positive for specific bacteriophage lysis

Definition of clinical illness

Clinical illness: the disease is characterized by fever, chills, headache, malaise, prostration, and leukocytosis that is manifest 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)
SOURCE: Plague ( )
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