Factors Influencing Atypical Clinical Presentations during the 2017 Madagascar Pneumonic Plague Outbreak: A Prospective Cohort Study.

Factors Influencing Atypical Clinical Presentations during the 2017 Madagascar Pneumonic Plague Outbreak: A Prospective Cohort Study. Am J Trop Med Hyg. 2020 Apr 06;: Authors: Salam AP, Raberahona M, Andriantsalama P, Read L, Andrianarintsiferantsoa F, Razafinambinintsoa T, Rakotomalala R, Hasiniatsy RNE, Razafimandimby D, Castle L, Funk A, Mangahasimbola RT, Renaud B, Bertherat E, Lovering A, Heraud JM, Andrianaivoarimanana V, Frédérique R, Razanajatovo N, Baril L, Fontanet A, Rajerison M, Horby P, Randria M, Randremanana R Abstract In late 2017, Madagascar experienced a large urban outbreak of pneumonic plague, the largest outbreak to date this century. During the outbreak, there were widespread reports of plague patients presenting with atypical symptoms, such as prolonged duration of illness and upper respiratory tract symptoms. Reported mortality among plague cases was also substantially lower than that reported in the literature (25% versus 50% in treated patients). A prospective multicenter observational study was carried out to investigate potential reasons for these atypical presentations. Few subjects among our cohort had confirmed or probable plague, suggesting that, in part, there was overdiagnosis of plague cases by clinicians. However, 35% subjects reported using an antibiotic with anti-plague activity before hospital admission, whereas 55% had antibiotics with anti-plague activity detected in their serum at admission...
Source: Am J Trop Med Hyg - Category: Infectious Diseases Authors: Tags: Am J Trop Med Hyg Source Type: research