![]() Enhanced surveillance plans should include how to: Additionally, state public health authorities and Centers for Disease Control and Prevention (CDC) staff will coordinate the epidemiologic investigation with other relevant state and federal authorities. Enhanced Surveillance and Case ReportingÄetection of human plague cases suspected of being linked to a bioterrorism event will require the state public health authority to initiate and coordinate active surveillance. Public health responders should work with medical providers to isolate patients with suspected or confirmed plague, monitor patient outcomes, and report data to state public health authorities. It is also important to identify others who may have been exposed but not yet developed symptoms, so they can begin immediate antimicrobial prophylaxis and fever watch. Identification of additional people with symptoms of plague will help investigators find the source of exposure and initiate appropriate treatment for those infected. Detailed information about places the patient has visited since the onset of cough to determine sites where additional people may have been exposed.Anyone with whom they had close (Symptoms, including cough or other respiratory symptoms.When interviewing symptomatic individuals in person, interviewers should take precautions including wearing appropriate personal protective equipment (PPE). Patients with pneumonic plague pose a risk for person-to-person transmission. Pneumonic plague is the most likely clinical manifestation following an intentional release of Yersinia pestis. ![]() The investigation will seek to identify and isolate the affected population and the epidemiologic features of the case(s). If bioterrorism is suspected, a joint investigation by public health and law enforcement officials will be required. Initially, it will be important to determine the source of the infection and whether it was naturally acquired or the result of bioterrorism. An epidemiologic investigation should begin as soon as a human case of plague has been detected. ![]()
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