Yersinia pestis infection primary prevention: Difference between revisions
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==Prophylactic Therapy== | ==Prophylactic Therapy== | ||
Post-exposure prophylaxis is indicated in persons who, in the previous six days: | *Post-exposure prophylaxis (PEP) is indicated in persons who, in the previous six days: | ||
* Have had close contact with pneumonic plague patients | ** Have had close contact with pneumonic plague patients | ||
* Are likely to have been exposed to [[Y. pestis]]-infected fleas | ** Are likely to have been exposed to [[Y. pestis]]-infected fleas | ||
* Are likely to have had direct contact with body fluids or tissues of a [[Y. pestis]]-infected mammal | ** Are likely to have had direct contact with body fluids or tissues of a [[Y. pestis]]-infected mammal | ||
* Were exposed during a laboratory accident to known [[infectious]] materials | ** Were exposed during a laboratory accident to known [[infectious]] materials | ||
The preferred [[antimicrobials]] for preventive or abortive therapy are the [[tetracyclines]], [[chloramphenicol]], or one of the effective [[sulfonamides]].<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | *The preferred [[antimicrobials]] for preventive or abortive therapy are the [[tetracyclines]], [[chloramphenicol]], or one of the effective [[sulfonamides]].<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | ||
True [[prophylaxis]], meaning the administration of an [[antibiotic]] prior to exposure, may be indicated when persons must be present for short periods in [[plague]]-active areas under circumstances in which exposure to plague sources (fleas, pneumonic cases) is difficult or impossible to prevent.<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | *True [[prophylaxis]], meaning the administration of an [[antibiotic]] prior to exposure, may be indicated when persons must be present for short periods in [[plague]]-active areas under circumstances in which exposure to plague sources (fleas, pneumonic cases) is difficult or impossible to prevent.<ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | ||
*Duration of post-exposure [[prophylaxis]] to prevent plague is 7 days. | |||
*The recommended [[antibiotic]] regimens for PEP are as follows: | |||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL><ref name="pmid10635759">{{cite journal| author=| title=Plague manual--epidemiology, distribution, surveillance and control. | journal=Wkly Epidemiol Rec | year= 1999 | volume= 74 | issue= 51-52 | pages= 447 | pmid=10635759 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10635759 }} </ref> | ||
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Revision as of 17:59, 25 July 2014
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Yersinia pestis infection Microchapters |
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Differentiating Yersinia Pestis Infection from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Yersinia pestis infection primary prevention On the Web |
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American Roentgen Ray Society Images of Yersinia pestis infection primary prevention |
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Risk calculators and risk factors for Yersinia pestis infection primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
A plague vaccine is not currently available for use in the United States. Preventive measures are directed to home, work, and recreational settings where the risk of acquiring plague is high.
Prophylactic Therapy
- Post-exposure prophylaxis (PEP) is indicated in persons who, in the previous six days:
- Have had close contact with pneumonic plague patients
- Are likely to have been exposed to Y. pestis-infected fleas
- Are likely to have had direct contact with body fluids or tissues of a Y. pestis-infected mammal
- Were exposed during a laboratory accident to known infectious materials
- The preferred antimicrobials for preventive or abortive therapy are the tetracyclines, chloramphenicol, or one of the effective sulfonamides.[1]
- True prophylaxis, meaning the administration of an antibiotic prior to exposure, may be indicated when persons must be present for short periods in plague-active areas under circumstances in which exposure to plague sources (fleas, pneumonic cases) is difficult or impossible to prevent.[1]
- Duration of post-exposure prophylaxis to prevent plague is 7 days.
- The recommended antibiotic regimens for PEP are as follows:
▸ Click on the following categories to expand treatment regimens.[1]
|
Plague Treatment ▸ Adult Patients ▸ Children ▸ Pregnant Patients |
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Hospital Precautions
Standard patient-care precautions should be applied to management of all suspected plague patients. These include prescribed procedures for:
- Handwashing
- Wearing of latex gloves and gowns
- Protective devices to protect mucous membranes of the eye, nose and mouth during those procedures and patient-care activities likely to generate splashes or sprays of blood, body fluids, secretions and excretions.
Additionally, a patient with suspected respiratory plague infection should be specifically managed under respiratory droplet precautions, including:
- Management in an individual room
- Restriction of movement of the patient outside the room
- Masking of the patient as well as persons caring for the patient until the patient is no longer infectious
Vaccination
Worldwide, live attenuated and formalin-killed Y. pestis vaccines are variously available for human use.
The vaccines are variably immunogenic and moderately to highly reactogenic. They do not protect against primary pneumonic plague.
In general, vaccinating communities against epizootic and enzootic exposures is not feasible; further, vaccination is of little use during human plague outbreaks, since a month or more is required to develop a protective immune response.
The vaccine is indicated for persons whose work routinely brings them into close contact with Y. pestis, such as:
- Laboratory technicians in plague reference research laboratories
- Persons studying infected rodent colonies