If the pathogen is transmitted as an aerosol by droplets or by contaminated dust, primary pneumonic plague
pestis in humans occurs in one of three primary clinical forms: bubonic plague is characterized by regional lymphadenopathy resulting from cutaneous or mucous membrane exposure, primary septicemic plague is an overwhelming plague bacteremia usually following cutaneous exposure, and primary pneumonic plague follows the inhalation of aerosolized droplets containing Y.
pestis to close patient contacts via respiratory droplet transmission can initiate an epidemic of primary pneumonic plague.
Since 1924, 3 (21%) of the 14 primary pneumonic plague
cases occurred in persons conducting laboratory or primate research on plague.
During 1924-2006, a total of 13 human cases of primary pneumonic plague
were documented in the United States, and [greater than or equal to] 5 were associated with felids (D.
To the Editor: A small outbreak of primary pneumonic plague took place in the Shimla District of Himachal Pradesh State in northern India during February 2002.
Primary pneumonic plague is acquired by inhaling infective droplets from persons or animals and rarely by accidental aerosol exposure.
However, the possibility of an intentional aerosol release of plague bacteria causing numerous contagious primary pneumonic plague cases has been a top concern of bioterrorism specialists (1).
Primary pneumonic plague developed in the primary caregivers, who displayed a more fulminant clinical course.
Persons with secondary pneumonic plague become infectious and can transmit the disease to other persons by the respiratory route, causing primary pneumonic plague (1,2).
As late as the 1990s, the Union of Soviet Socialist Republics was developing plague as an aerosol agent to cause primary pneumonic plague in target populations (9).
The natural course of bubonic plague can lead to secondary pneumonic plague, which can give rise to highly contagious cases of primary pneumonic plague
in contacts, as seen every year in the highlands of Madagascar (17).