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Ebola: Information for U.S. Healthcare Workers and Settings

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Disease Name: Plague


Quick Links

Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Plague prevention: http://www.cdc.gov/plague/prevention/index.html


Overview / 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:

Laboratory criteria for diagnosis

Case classification


Restrictions

Daycare Facility

A person who is diagnosed with pneumonic plague must not work in any occupation in which there is direct contact with children, or attend a daycare facility, as long as the disease is in a communicable form.

Health Care Facility

a. A person with or suspected of having pneumonic plague in a health care facility must be managed under the “Guideline for Isolation Precautions in Hospitals,” as incorporated in Section 004 of these rules.

b. A person with or suspected of having bubonic plague in health care facility must be managed under the “Guideline for Isolation Precautions in Hospitals,” as incorporated in Section 004 of these rules.

School

A person diagnosed with pneumonic plague must not attend or work in any occupation in which there is direct contact with children, in a private, parochial, charter, or public school as long as the disease is in a communicable form.

Prophylaxis of Contacts

Household members and face-to-face contacts of a person with pneumonic plague must be placed on chemoprophylaxis and placed under surveillance for seven (7) days. A person who refuses chemoprophylaxis must be maintained under droplet precautions with careful surveillance for seven (7) days.


Reporting

Immediately, at the time of identification

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable: Yes

Reporting Timeframe: Immediately, at the time of identification



Diagnosis / Testing

The Idaho Bureau of Laboratories (IBL) is capable of testing for plague by a number of methods which include a direct fluorescent antibody (DFA) test, culture, and PCR. Contact IBL (208-334-2235) before submitting any human, rodent, or other animal specimens for plague testing. The state laboratory does not provide serologic testing. Any serologic test request would be forwarded to CDC for testing. Y. pestis is a small gram-negative and/or bipolar-staining coccobacillus with a characteristic “safety pin” appearance when viewing a stained bubo aspirate, blood smear, sputum, or CSF sample under the microscope. Direct visualization is suggestive, but not confirmatory evidence of plague.


Treatment

CDC resources for clinicians: http://www.cdc.gov/plague/healthcare/clinicians.html


Additional Information

Plague prevention: http://www.cdc.gov/plague/prevention/index.html


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