Journal Article

Primary Pneumonic Plague Contracted from a Mountain Lion Carcass

David Wong, Margaret A. Wild, Matthew A. Walburger, Charles L. Higgins, Michael Callahan, Lawrence A. Czarnecki, Elisabeth W. Lawaczeck, Craig E. Levy, J. Gage Patterson, Rebecca Sunenshine, Patricia Adem, Christopher D. Paddock, Sherif R. Zaki, Jeannine M. Petersen, Martin E. Schriefer, Rebecca J. Eisen, Kenneth L. Gage, Kevin S. Griffith, Ingrid B. Weber, Terry R. Spraker and Paul S. Mead

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 49, issue 3, pages e33-e38
Published in print August 2009 | ISSN: 1058-4838
Published online August 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/600818
Primary Pneumonic Plague Contracted from a Mountain Lion Carcass

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Background. Primary pneumonic plague is a rare but often fatal form of Yersinia pestis infection that results from direct inhalation of bacteria and is potentially transmissible from person to person. We describe a case of primary pneumonic plague in a wildlife biologist who was found deceased in his residence 1 week after conducting a necropsy on a mountain lion.

Methods. To determine cause of death, a postmortem examination was conducted, and friends and colleagues were interviewed. Physical evidence was reviewed, including specimens from the mountain lion and the biologist's medical chart, camera, and computer. Human and animal tissues were submitted for testing. Persons in close contact (within 2 meters) to the biologist after he had developed symptoms were identified and offered chemoprophylaxis.

Results. The biologist conducted the necropsy in his garage without the use of personal protective equipment. Three days later, he developed fever and hemoptysis and died ∼6 days after exposure. Gross examination showed consolidation and hemorrhagic fluid in the lungs; no buboes were noted. Plague was diagnosed presumptively by polymerase chain reaction and confirmed by culture. Tissues from the mountain lion tested positive for Y. pestis, and isolates from the biologist and mountain lion were indistinguishable by pulsed-field gel electrophoresis. Among 49 contacts who received chemoprophylaxis, none developed symptoms consistent with plague.

Conclusions. The biologist likely acquired pneumonic plague through inhalation of aerosols generated during postmortem examination of an infected mountain lion. Enhanced awareness of zoonotic diseases and appropriate use of personal protective equipment are needed for biologists and others who handle wildlife.

Journal Article.  3472 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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