West Virginia Department of Health and Human Resources Plague: Information for Public Health Officials


Unique Epidemiological Characteristics

  • No natural reservoir in West Virginia
  • A newly reported case should be urgently investigated considering:
    • travel to endemic area
    • importation of and exposure to an ill animal
    • BT
  • Incubation: 1-6 days by inhalation
  • Person-to-person transmission via droplets
  • Mortality: 100% without therapy – dire emergency
  • Environmental: bacteria is NOT long-lasting in the environment
  • Prophylaxis: effective with ciprofloxacin, doxycycline
  • Treatment: effective if begun early with streptomycin, gentamicin > cipro/doxy

Laboratory confirmation

  • Screening tests can be done by a hospital lab; confirmation by OLS

Employee health considerations

  • Exposed employees should be offered prophylaxis
  • Droplet precautions; employees who will have face-to-face contact with plague victims should be supplied with surgical masks

Lifesaving interventions – in order:

  1. Recognition / reporting / case-finding (fever or cough in the setting of a known outbreak of plague) + early and appropriate therapy
  2. Droplet isolation of cases
  3. Contact tracing and prophylaxis
  4. Collect and analyze risk information to identify source AND identify the exposed population to be offered prophylaxis and placed under surveillance.
  5. Susceptibility testing; dissemination of susceptibility results

Training considerations

  • Physicians: recognition / treatment / reporting
  • ICPs: reporting, active surveillance procedures
  • Local health departments, regional epidemiologists: investigation
  • IDEP / DSDC / BPH: employee health / investigation / priorities for control


Related Links

CDC - Plague Page