Eurosurveillance, Volume
9, Issue
12,
01 December 2004
Guidelines
Bichat guidelines for the clinical management of plague and bioterrorism-related plague
P Bossi1, A Tegnell2, A Baka3, F van Loock2, A Werner2, J Hendriks4, Heinrich Maidhof2, Georgios Gouvras2
Citation style for this article: Bossi P, Tegnell A, Baka A, van Loock F, Werner A, Hendriks J, Maidhof H, Gouvras G. Bichat guidelines for the clinical management of plague and bioterrorism-related plague. Euro Surveill. 2004;9(12):pii=501. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=501
Date of submission:
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Philippe Bossi*, Anders Tegnell, Agoritsa Baka, Frank Van Loock, Jan
Hendriks, Albrecht Werner, Heinrich Maidhof, Georgios Gouvras
Task Force on Biological and Chemical Agent Threats, Public Health Directorate,
European Commission, Luxembourg
*Corresponding author: P. Bossi, Pitié-Salpêtrière
Hospital, Paris, France, email: philippe.bossi@psl.ap-hop-paris.fr
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Yersinia pestis appears
to be a good candidate agent for a bioterrorist attack. The use of an
aerosolised form of this agent could cause an explosive outbreak of primary
plague pneumonia. The bacteria could be used also to infect the rodent
population and then spread to humans. Most of the therapeutic guidelines
suggest using gentamicin or streptomycin as first line therapy with ciprofloxacin
as optional treatment. Persons who come in contact with patients with
pneumonic plague should receive antibiotic prophylaxis with doxycycline
or ciprofloxacin for 7 days. Prevention of human-to-human transmission
via patients with plague pneumonia can be achieved by implementing standard
isolation procedures until at least 4 days of antibiotic treatment have
been administered. For the other clinical types of the disease, patients
should be isolated for the first 48 hours after the initiation of treatment.
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