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Volume 17, Number 5—May 2011


Lessons Learned about Pneumonic Plague Diagnosis from 2 Outbreaks, Democratic Republic of the Congo

Eric BertheratComments to Author , Philippe Thullier, Jean Christophe Shako, Kathleen England, Mamadou-Lamine Koné, Lorraine Arntzen, Herbert Tomaso, Louis Koyange, Pierre Formenty, Florent Ekwanzala, Rosa Crestani, Isa Ciglenecki, and Lila Rahalison
Author affiliations: Author affiliations: World Health Organization, Geneva, Switzerland (E. Bertherat, P. Formenty); Centre de Recherche du Service de Santé des Armées, Grenoble, France (P. Thullier); Plague Reference Laboratory, Bunia, Democratic Republic of the Congo (J.C. Shako); National Institutes of Health, Bethesda, Maryland, USA (K. England); World Health Organization, Brazzaville, Republic of Congo (M.-L. Koné); National Health Laboratory Service, Johannesburg, South Africa (L. Arntzen); Bundeswehr Institute of Microbiology, Munich, Germany (H. Tomaso); Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo (L. Koyange); World Health Organization, Kinshasa (F. Ekwanzala); Médecins Sans Frontière, Bruxelles, Belgium (R. Crestani); Médecins sans Frontières, Geneva (I. Ciglenecki); Institut Pasteur, Antananarivo, Madagascar (L. Rahalison)

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Laboratory results for 87 and 117 suspected cases of pneumonic plague during outbreaks in 2005 and 2006, respectively, Democratic Republic of Congo*

Location, year No. cases for which samples were collected from patients No. positive samples/no. tested (% positive)
RDT Microscopy Yersinia pestis isolation DFA PCR IgG
Zobia, 2005†
Acute, 44 17/35 (48.6) 31/44 (70.4) 0/44 6/43 (13.9) 2/42 (4.8) 7/18 (3.9)
Paired samples, 6 1/2 (50) 1/2 (50) NA 0/2 0/2 6//12 (50.0)
Convalescent, 37
12/37 (3.2)
Bole, 2006‡ Acute, 98 23/96 (24.0) 38/67 (56.7) 4/96 (4.2) NA NA 2/89 (2.2)
Convalescent, 19 NA NA NA NA NA 0/19 (0)

*RDT, rapid diagnostic test; DFA, direct fluorescent antibody test; PCR, real-time PCR; Ig, immunoglobulin; NA, not applicable.
†Of 130 cases identified, samples were collected from 87 patients.
‡Of 162 cases identified, samples were collected from 117 patients.

Main Article