The plague bacterium (Yersinia pestis) exists in enzootic cycles of rodents and their fleas in the western United States. People are infected with the plague bacterium through flea bites and direct contact with infected animal tissues or fluids. People are also infected by inhalation of droplets coughed by an infected human or animal. Plague is a febrile illness that typically manifests into one or more clinical syndromes, often reflecting the route of exposure to the bacterium. These clinical syndromes include bubonic, septicemic, and pneumonic plague. Several classes of antibiotics are effective against plague. Plague can be rapidly fatal if appropriate antimicrobial therapy is not initiated early in illness.
An illness characterized by acute onset of fever as reported by the patient or healthcare provider with or without one or more of the following specific clinical manifestations:
Confirmatory
Presumptive
*Other laboratory tests, including rapid bedside tests, are in use in some low resourced international settings but are not recommended as laboratory evidence of plague infection in the United States.
Confirmed: A clinically-compatible case with confirmatory laboratory evidence, OR a clinically-compatible case with presumptive laboratory evidence AND epidemiologic linkage.
Probable: A clinically-compatible case with presumptive laboratory evidence without epidemiologic linkage in absence of an alternative diagnosis
Suspect: A clinically-compatible case with epidemiologic linkage without laboratory evidence OR confirmed or presumptive laboratory evidence without any associated clinical information.
The 1996 case definition appearing on this page was re-published in the 2009 CSTE position statement 09-ID-52. Thus, the 1996 and 2010 versions of the case definition are identical.
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