A Cluster of Primary Pneumonic Plague Transmitted in a Truck Cab in a New Enzootic Focus in China

Huiming Luo Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Xingqi Dong Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Furong Li Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Xu Xie Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Zhizhong Song Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Zhujun Shao Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Zhongjie Li Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Zhaohui Tong Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Guangfa Wang Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Hongtao Zhang Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Tielong Yang Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Gao He Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Zeyuan He Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Robert E. Fontaine Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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Guang Zeng Chinese Field Epidemiology Training Program, Beijing, 100050, China; Yunnan Provincial Endemic Disease Prevention Institute, Dali, China; Chinese Center for Disease Control and Prevention, Beijing, China; Capital Medical College Affiliated Beijing Chaoyang Hospital, Beijing, China; Peking University First Hospital, Beijing, China; Lijiang Center for Disease Control and Prevention, Yunnan, China; Yulong Center for Disease Control and Prevention, Yunnan, China; United States Centers for Disease Control and Prevention, Atlanta, Georgia

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DOI:
https://doi.org/10.4269/ajtmh.12-0163
Volume/Issue:
Volume 88: Issue 5
Page(s):
923–928
Restricted access
Get Permissions

We investigated a cluster of five cases of severe pneumonia from one village in Yunnan Province, China. We searched for severe pneumonia in the village and hospitals. We interviewed patients and family members about exposures. We tested acute and convalescent sera for antigen and antibody of severe acute respiratory syndrome, avian influenza, and plague. The only common exposure of the five patients was riding together in the enclosed cab of a truck for 1.5 hours while taking the first patient to the hospital. Seroconversion to plague F1 antigen confirmed plague in three survivors. Unfamiliarity of clinicians with plague and lack of sputum examination, blood culture, or postmortem examination delayed the diagnosis. No plague cases occurred among family and village contacts and health care workers. High infectivity in this cluster was limited to a crowded, poorly ventilated truck.

Author Notes

* Address correspondence to Guang Zeng, Beijing, China FETP, Office of China CDC, Beijing, 100050, China. E-mail: zeng4605@vip.sina.com
† These authors contributed equally to this work.

Authors' addresses: Huiming Luo, Furong Li, Xu Xie, and Guang Zeng, Chinese Center for Disease Control and Prevention, Chinese Field Epidemiology Training Program, Beijing, China, E-mails: hmluo@vip.sina.com, lifurong2005@yahoo.com.cn, xiexv@hotmail.com, and zeng4605@vip.sina.com. Xingqi Dong and Zhizhong Song, Yunnan Provincial Endemic Disease Prevention Institute – Office, Dali, China, E-mails: Dongxq99@vip.sina.com and 13808766541@126.com. Zhujun Shao and Zhongjie Li, Chinese Center for Disease Control and Prevention, Control and Prevention for Infectious Disease, Beijing, China, E-mails: shaozhujun@126.com and lizhongjiecdc@163.com. Zhaohui Tong, Capital Medical College Affiliated Beijing Chaoyang Hospital - Internal Medicine, Beijing, China, E-mail: tongzhh@hotmail.com. Guangfa Wang, Peking University First Hospital - Internal Medicine, Beijing, China, E-mail: wangguangfa@hotmail.com. Hongtao Zhang and Tielong Yang, Lijiang Center for Disease Control and Prevention, Epidemiological Department, Beijing, China, E-mails: zhtaozr@126.com and ytl19531205@yahoo.com.cn. Gao He and Zeyuan He, Yulong Center for Disease Control and Prevention, Epidemiological Department, Beijing, China, E-mails: hg13308889009@yahoo.com.cn and ljlizhaoxiu@163.com. Robert E. Fontaine, United States Centers for Disease Control and Prevention, Division of Public Health Systems and Workforce Development, Atlanta, GA, E-mail: ref1@cdc.gov.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2013
Received:
13 Mar 2012
|
Accepted:
28 Dec 2012
|
Published Online:
01 May 2013
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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