Editing Pneumonic plague

{{short description|Severe lung infection}}
{{Use dmy dates|date=June 2022}}
{{Infobox medical condition (new)
| name = Pneumonic plague
| image = Yersinia pestis.jpg
| alt = 
| caption = A scanning electron micrograph depicting a mass of ''Yersinia pestis'' bacteria
| pronounce = 
| specialty = Infectious disease
| symptoms = Fever, headache, shortness of breath, cough, [[hemoptysis]]<ref name=CDC2015/>
| onset = 3 to 7 days<ref name=WHO2016Fact/>
| duration = 
| causes = ''[[Yersinia pestis]]''<ref name=WHO2017/>
| risks = [[Rodents]]<ref name=WHO2017/>
| diagnosis = [[Sputum]] testing<ref name=CDC2015/>
| differential = 
| prevention = 
| treatment = [[Antibiotics]]<ref name=CDC2015/>
| medication = 
| frequency = 3% of all Plague cases (CDC MMWR 2015) <ref>{{Cite web |date=28 August 2015 |title=Human Plague — United States, 2015 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a6.htm |url-status=live |archive-url=https://web.archive.org/web/20250211174113/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a6.htm |archive-date=11 February 2025 |access-date=14 March 2025 |website=www.cdc.gov}}</ref>
| prognosis = Nearly 100% fatal if untreated<ref>https://web.archive.org/web/20170131062743/http://www.cfsph.iastate.edu/Factsheets/pdfs/plague.pdf</ref>
| deaths = 
}}

<!-- Definition and symptoms -->
'''Pneumonic plague''' is a severe [[lung infection]] caused by the [[bacterium]] ''[[Yersinia pestis]]''.<ref name=WHO2017/> Symptoms include [[fever]], headache, [[shortness of breath]], [[chest pain]], and coughing.<ref name=CDC2015/> They typically start about three to seven days after exposure.<ref name=WHO2016Fact/> It is one of three forms of [[Plague (disease)|plague]], the other two being [[septicemic plague]] and [[bubonic plague]].<ref name=WHO2017/>

<!-- Cause, mechanism, and diagnosis -->
The pneumonic form may occur following an initial bubonic or septicemic plague infection.<ref name=WHO2017>{{cite web|title=Plague|url=https://www.who.int/ith/diseases/plague/en/|website=www.who.int|access-date=14 March 2017|url-status=dead|archive-url=https://web.archive.org/web/20170319114939/http://www.who.int/ith/diseases/plague/en/|archive-date=19 March 2017}}</ref> It may also result from breathing in [[airborne disease|airborne]] droplets from another person or animal infected with pneumonic plague.<ref name=CDC2015>{{cite web|title=FAQ Plague|url=https://www.cdc.gov/plague/faq/|website=www.cdc.gov|access-date=13 March 2017|url-status=live|archive-url=https://web.archive.org/web/20170314062829/https://www.cdc.gov/plague/faq/|archive-date=14 March 2017}}</ref> The difference between the forms of plague is the location of infection; in pneumonic plague the infection is in the lungs, in bubonic plague the [[lymph nodes]], and in septicemic plague within the blood.<ref name=WHO2017/> Diagnosis is by testing the blood, sputum, or fluid from a lymph node.<ref name=CDC2015/>

<!-- Prevention and treatment -->
While [[vaccine]]s are being developed, in most countries they are not yet commercially available.<ref name=CDC2015/><ref name=WHO2017/> Prevention is by avoiding contact with infected rodents, people, or cats.<ref name=CDC2015/><ref name=WHO2017/> It is recommended that those infected be [[isolation (health care)|isolated]] from others.<ref name=WHO2016Fact>{{cite web|title=Plague|url=https://www.who.int/mediacentre/factsheets/fs267/en/|website=World Health Organization|access-date=14 March 2017|date=September 2016|url-status=live|archive-url=https://web.archive.org/web/20150424065540/http://www.who.int/mediacentre/factsheets/fs267/en/|archive-date=24 April 2015}}</ref> Treatment of pneumonic plague consists of [[antibiotic]]s.<ref name=CDC2015/>

<!-- Epidemiology and history -->
Plague is present among rodents in Africa, the Americas, and Asia.<ref name=WHO2017/> Pneumonic plague is more serious and less common than bubonic plague.<ref name=CDC2015/> The total reported number of cases of all types of plague in 2013 was 783.<ref name=WHO2016Fact/> Left untreated, pneumonic plague is almost always fatal.<ref>http://www.cfsph.iastate.edu/Factsheets/pdfs/plague.pdf</ref> Some hypothesize that the pneumonic version of the plague was mainly responsible for the [[Black Death]] that resulted in approximately 75 - 200 million deaths in the 1300s.<ref name=WHO2016Fact/><ref>{{cite news|last1=McCoy|first1=Terrence|title=Everything you know about the Black Death is wrong|url=https://www.washingtonpost.com/news/morning-mix/wp/2014/03/31/everything-you-know-about-the-black-death-is-wrong-say-the-bones/|access-date=14 March 2017|newspaper=Washington Post|agency=The Washington Post|date=31 March 2014|url-status=live|archive-url=https://web.archive.org/web/20160827172208/https://www.washingtonpost.com/news/morning-mix/wp/2014/03/31/everything-you-know-about-the-black-death-is-wrong-say-the-bones/|archive-date=27 August 2016}}</ref>

==Signs and symptoms==
The most apparent symptom of pneumonic plague is coughing, often with [[hemoptysis]] (coughing up blood). With pneumonic plague, the first signs of illness are fever, headache, weakness and rapidly developing pneumonia with shortness of breath, chest pain, cough and sometimes bloody or watery [[sputum]].<ref name="CDC" />

The pneumonia progresses for two to four days and may cause respiratory failure and [[Shock (circulatory)|shock]]. Patients will die without early treatment, some within 36 hours.{{cn|date=January 2023}}

Initial pneumonic plague symptoms can often include the following:{{cn|date=January 2023}}
* [[Fever]]
* [[muscle weakness|Weakness]]
* [[Headaches]]
* [[Nausea]]

Rapidly developing [[pneumonia]] with:{{cn|date=January 2023}}
* [[Shortness of breath]]
* [[Chest pain]]
* [[Cough]]
* Bloody or watery [[sputum]] (saliva and discharge from [[respiratory passages]]).

==Causes==
Pneumonic plague can be caused in two ways: primary, which results from the inhalation of aerosolized plague [[bacteria]], or secondary, when [[septicemic plague]] spreads into [[lung]] tissue from the bloodstream. Pneumonic plague is ''not'' exclusively [[Vector (epidemiology)|vector-borne]] like bubonic plague; instead, it can be spread from person to person. There have been cases of pneumonic plague resulting from the dissection or handling of contaminated animal tissue. This is one of the types of plague formerly known as the [[Black Death]].<ref>{{cite book | title=The Black Death, 1346–1353: The Complete History | first=Ole Jørgen | last=Benedictow | publisher=Boydell & Brewer | year=2004 | isbn=0-85115-943-5 | pages=27–28 }}</ref>

==Treatment==
Pneumonic plague is a very aggressive infection requiring early treatment, which must be given within 24 hours of first symptoms to reduce the risk of death.<ref name="CDC">[http://www.bt.cdc.gov/agent/plague/factsheet.asp Facts about Pneumonic Plague (Center for Disease Control, 2004)] {{webarchive|url=https://web.archive.org/web/20130802185510/http://www.bt.cdc.gov/agent/plague/factsheet.asp |date=2 August 2013 }}</ref> [[Streptomycin]], [[gentamicin]], [[tetracycline]]s and [[chloramphenicol]] are all able to kill the causative bacterium.{{cn|date=January 2023}}

Antibiotic treatment for seven days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection.<ref name="CDC" />

The mortality rate from untreated pneumonic plague approaches 100% although victims of the [[Black Death]] who vomited blood occasionally survived such as the chronicler Marcha di Marco Battagli.<ref name="ISU">[http://www.cfsph.iastate.edu/Factsheets/pdfs/plague.pdf Plague] {{webarchive|url=https://web.archive.org/web/20170131062743/http://www.cfsph.iastate.edu/Factsheets/pdfs/plague.pdf |date=31 January 2017 }}. (Iowa State University, 2004)</ref><ref>Samuel Cohn's ''The Black Death Transformed: Disease and Culture in Early Renaissance Europe'', pg 93.</ref>

==Modern outbreaks==
Since 2002, the [[World Health Organization]] (WHO) has reported seven plague outbreaks, though some may go unreported because they often happen in remote areas. Between 1998 and 2009, nearly 24,000 cases have been reported, including about 2,000 deaths, in Africa, Asia, the Americas, and Eastern Europe. Ninety-eight percent of the world's cases occur in Africa.

===Democratic Republic of the Congo===
Two outbreaks occurred in the Democratic Republic of the Congo in 2005 and 2006.<ref name="bertherat11">{{cite journal |doi=10.3201/eid1705.100029|title=Lessons Learned about Pneumonic Plague Diagnosis from 2 Outbreaks, Democratic Republic of the Congo|year=2011|last1=Bertherat|first1=Eric|last2=Thullier|first2=Philippe|last3=Shako|first3=Jean Christophe|last4=England|first4=Kathleen|last5=Koné|first5=Mamadou-Lamine|last6=Arntzen|first6=Lorraine|last7=Tomaso|first7=Herbert|last8=Koyange|first8=Louis|last9=Formenty|first9=Pierre|last10=Ekwanzala|first10=Florent|last11=Crestani|first11=Rosa|last12=Ciglenecki|first12=Isa|last13=Rahalison|first13=Lila|journal=Emerging Infectious Diseases|volume=17|issue=5|pages=778–84|pmid=21529384|pmc=3321750}}</ref> The outbreak in 2005 was only detected by looking back at blood samples.<ref name="bertherat11"/>
The total death toll was 111.

===India===

In September 1994, India experienced an outbreak of plague that killed 50 and caused travel to [[New Delhi]] by air to be suspended until the outbreak was brought under control.<ref>Plague Fears Cancel Flights. The Daily Gleaner, 1 October 1994.</ref> The outbreak was feared to be much worse because the plague superficially resembles other common diseases such as influenza and bronchitis; over 200 people that had been quarantined were released when they did not test positive for the plague.<ref>Plague Fears Beginning to Recede. The Daily Gleaner, 2 October 1994.</ref> All but three of the deaths occurred around the city of [[Surat]].<ref>{{Cite journal |last=Mavalankar |first=D. V. |date=October 1995 |title=Indian 'plague' epidemic: unanswered questions and key lessons |journal=Journal of the Royal Society of Medicine |language=en |volume=88 |issue=10 |pages=547–551 |pmc=1295353 |pmid=8537942}}</ref>

===China===
A major outbreak of the pneumonic plague occurred in [[Manchuria]] from 1910 to 1911, in what became known as the [[Manchurian plague]], killing around 60,000 people.<ref name="welford09">{{cite journal |last1=Welford |first1=Mark R. |last2=Bossak |first2=Brian H. |last3=Carter |first3=Dee A. |title=Validation of Inverse Seasonal Peak Mortality in Medieval Plagues, Including the Black Death, in Comparison to Modern Yersinia pestis-Variant Diseases |journal=PLOS ONE |date=22 December 2009 |volume=4 |issue=12 |pages=e8401 |doi=10.1371/journal.pone.0008401|pmid=20027294 |pmc=2791870 |bibcode=2009PLoSO...4.8401W |doi-access=free }}</ref> The [[Qing dynasty|Qing court]] dispatched [[Wu Lien-teh]], a doctor educated at [[Cambridge University]], to oversee disease control and treatment efforts. He made the novel observation that the disease was [[Airborne disease|transmitted by air]], and developed prototypical [[respirator]]s to help prevent its spread.<ref name=welford20>{{cite web |last1=Wilson |first1=Mark |title=The untold origin story of the N95 mask |url=https://www.fastcompany.com/90479846/the-untold-origin-story-of-the-n95-mask |website=Fast Company |date=24 March 2020}}</ref> A second, less deadly outbreak occurred in 1920–21, killing approximately 9,300 people.<ref name="welford09"/>

The [[People's Republic of China]] has eradicated pneumonic plague from most parts of the country, but still reports occasional cases in remote [[Western China|western]] areas, where the disease is carried by [[rat]]s and the [[marmot]]s that live across the [[Himalayan plateau]]. Outbreaks can be caused when a person eats an infected marmot or comes into contact with fleas carried by rats. A 2006 WHO report from an international meeting on plague cited a Chinese government disease expert as saying that most cases of the plague in [[Northwest China|China's northwest]] occur when hunters are contaminated while skinning infected animals.<ref name="China disinfects"/>

The expert said at the time that, due to the region's remoteness, the disease killed more than half the infected people. The report also said that since the 1990s, there was a rise in plague cases in humans—from fewer than 10 in the 1980s to nearly 100 cases in 1996 and 254 in 2000.<ref>Macartney, Jane (3 August 2009). [http://www.timesonline.co.uk/tol/life_and_style/health/article6736993.ece Entire town in quarantine after two die from pneumonic plague in China] {{webarchive|url=https://web.archive.org/web/20110429053006/http://www.timesonline.co.uk/tol/life_and_style/health/article6736993.ece |date=29 April 2011 }}. ''[[The Times]]'' (London).</ref> In September 2008, two people in [[East Tibet]] died of pneumonic plague.<ref>{{cite web|url=http://www.tibet.ca/en/library/wtn/4184|archive-url=https://web.archive.org/web/20091114020348/http://www.tibet.ca/en/newsroom/wtn/4184|url-status=dead|title=Canada Tibet Committee &#124; Library &#124; WTN|archive-date=14 November 2009|website=www.tibet.ca}}</ref>

An outbreak of the disease in China began in August 2009 in [[Ziketan Town]] located in [[Qinghai Province]]. The town was sealed off and several people died as a result of the disease.<ref name="China disinfects">{{cite news | title = China disinfects town where plague killed 3rd man | url = https://www.google.com/hostednews/ap/article/ALeqM5iLFGFVYaEEFibpJ7MThpiQsgInWQD99RVPLO1 | agency = Associated Press | date = 4 August 2009 | url-status = dead | archive-url = https://web.archive.org/web/20090808004634/http://www.google.com/hostednews/ap/article/ALeqM5iLFGFVYaEEFibpJ7MThpiQsgInWQD99RVPLO1 | archive-date = 8 August 2009 }}</ref><ref name="4th plague patient near death in NW China province">{{cite news | title = 4th plague patient near death in NW China province | url = http://news.xinhuanet.com/english/2009-08/05/content_11826797.htm | publisher = Xinhua | date = 5 August 2009 | url-status = dead | archive-url = https://web.archive.org/web/20090808151247/http://news.xinhuanet.com/english/2009-08/05/content_11826797.htm | archive-date = 8 August 2009 }}</ref> According to spokesperson Vivian Tan of the WHO office in [[Beijing]], "In cases like this [in August 2009], we encourage the authorities to identify cases, to investigate any suspicious symptoms among close contacts, and to treat confirmed cases as soon as possible. So far, they have done exactly that. There have been sporadic cases reported around the country in the last few years so the authorities do have the experience to deal with this."<ref>[http://english.aljazeera.net/news/asia-pacific/2009/08/2009837311848754.html Alert over China plague outbreak] {{webarchive|url=https://web.archive.org/web/20090803100452/http://english.aljazeera.net/news/asia-pacific/2009/08/2009837311848754.html |date=3 August 2009 }}. [[Al Jazeera Arabic|Al Jazeera]]. 3 August 2009.</ref>

In September 2010, five cases of pneumonic plague were reported in Tibet.<ref name=Dawa2011>{{cite journal|pmid=21781509|year=2011|last1=Dawa|first1=W|title=Clinical features, diagnosis and treatment of 5 cases of primary pneumonic plague in Tibet in 2010|journal=Zhonghua jie he<!--sic erat scriptum--> he hu xi za zhi |volume=34|issue=6|pages=404–08|last2=Pan|first2=W. J.|last3=Gu|first3=X. Y.|last4=Zhang|first4=S. Q.|last5=Dawa|first5=C|last6=Yi|first6=X|last7=Ciwang|first7=Z|last8=Wang|first8=Y|last9=Li|first9=S. Y.|last10=Jiang|first10=R. M.}}</ref>

In July 2014, Chinese media reported one case found in Gansu.<ref>{{cite web|url=http://www.chinadaily.com.cn/china/2014-07/18/content_17840795.htm|title=151 quarantined in Gansu after plague death – China |website= Chinadaily.com.cn|date=18 July 2014|access-date=30 January 2018|url-status=bot: unknown|archive-url=https://web.archive.org/web/20140718175938/http://www.chinadaily.com.cn/china/2014-07/18/content_17840795.htm|archive-date=18 July 2014}}</ref>

On 12 November 2019, It was announced that two people from the Chinese province of [[Inner Mongolia]] were diagnosed with pneumonic plague. They received treatment in [[Chaoyang District, Beijing]], and authorities implemented preventative control measures.<ref>{{cite news |last1=Yeung|first1=Jessie  |title=Two people got the plague in China. Why is it still a thing? |url=https://edition.cnn.com/2019/11/13/health/china-plague-intl-hnk-scn-scli/index.html |access-date=14 November 2019 |work=CNN}}</ref> Later in November, a third case of plague was confirmed. A 55-year-old man was diagnosed with [[bubonic plague]] after eating wild rabbit in Inner Mongolia. The region's health commission says it has no evidence to suggest that this case is linked to the previous two.<ref>{{cite web|url=https://www.vox.com/future-perfect/2019/11/14/20963154/plague-china-pneumonic-bubonic-pandemic-preparedness|title=We never really got rid of the plague. 3 people in China just caught it.|first=Sigal|last=Samuel|date=14 November 2019|website=Vox|access-date=25 July 2020}}</ref> By the end of November, a fourth case was confirmed. Chinese health authorities reported a fresh case of bubonic plague in the country's northern Inner Mongolia region, bringing the total number of reported plague cases originating from Inner Mongolia to four.<ref>{{cite news|url=https://www.reuters.com/article/us-china-health-plague-idUSKBN1Y20BI|title=China reports fourth case of plague this month|newspaper=Reuters|date=28 November 2019|access-date=25 July 2020|via=www.reuters.com}}</ref>

===Peru===
In August 2010, Peru's health minister Oscar Ugarte announced that an outbreak of plague had killed a 14-year-old boy and had infected at least 31 people in a northern coastal province. The boy died of bubonic plague on 26 July 2010. Ugarte stated that authorities were screening sugar and fish meal exports from [[Ascope Province]], located about 325 miles (520&nbsp;km) northwest of [[Lima]], not far from the popular [[Puerto Chicama|Chicama beach]]. Most of the infections in Peru were bubonic plague, with four cases of pneumonic plague.<ref>[https://www.telegraph.co.uk/news/worldnews/southamerica/peru/7925151/Peru-suffers-deadly-outbreak-of-bubonic-and-pneumonic-plague.html Peru suffers deadly outbreak of bubonic and pneumonic plague] {{webarchive|url=https://web.archive.org/web/20130204210500/http://www.telegraph.co.uk/news/worldnews/southamerica/peru/7925151/Peru-suffers-deadly-outbreak-of-bubonic-and-pneumonic-plague.html |date=4 February 2013 }}, ''The Telegraph'', 3 August 2010. Accessed 4 November 2014.</ref>

The first recorded plague outbreak in Peru was in 1903. Prior to the above case, the last known outbreak was in 1994, killing 35 people.<ref>{{cite web |url=http://blog.taragana.com/health/2010/08/02/perus-health-minister-says-plague-outbreak-has-killed-teenager-infected-at-least-31-people-25654/ |title=Peru's health minister says plague outbreak has killed teenager, infected at least 31 people |access-date=3 August 2010 |url-status=dead |archive-url=https://web.archive.org/web/20100817074548/http://blog.taragana.com/health/2010/08/02/perus-health-minister-says-plague-outbreak-has-killed-teenager-infected-at-least-31-people-25654/ |archive-date=17 August 2010 }}</ref>

===Madagascar===
[[File:Medical team working together during the plague period in Madagascar.jpg|thumb|Medical team working together during a plague outbreak in Madagascar (October 2017).]]
In November 2013, an outbreak of plague occurred in the [[Africa]]n island nation of [[Madagascar]].<ref>{{cite web|url=https://www.theaustralian.com.au/news/world/pneumonic-plague-kills-39-in-madagascar/news-story/285b6a6673b1ab71936dbe14c9be13a7|title=Plague kills 39 in Madagascar|date=12 December 2013|website=www.theaustralian.com.au}}</ref> As of 16 December, at least 89 people were infected, with 39 deaths<ref>{{cite news |url=https://www.bbc.co.uk/news/world-africa-25342122 |title=Madagascar hit by 'deadlier plague' |access-date=16 December 2013 |url-status=live |archive-url=https://web.archive.org/web/20131216143609/http://www.bbc.co.uk/news/world-africa-25342122 |archive-date=16 December 2013 |work=BBC News |date=11 December 2013 }}</ref> with at least two cases involving pneumonic plague. However, as many as 90% of cases were later reported to have involved pneumonic plague.<ref>[http://www.scmp.com/news/world/article/1379280/bubonic-plague-worse-black-death-kills-39-madagascar "Bubonic plague 'worse than Black Death' kills 39 in Madagascar"] {{webarchive|url=https://web.archive.org/web/20131216070948/http://www.scmp.com/news/world/article/1379280/bubonic-plague-worse-black-death-kills-39-madagascar |date=16 December 2013 }}, ''South China Morning Post'', 12 December 2013. Accessed 4 November 2014.</ref>

From 23 August to 30 September 2017, a total of 73 suspected, probable, and confirmed cases of pneumonic plague, including 17 deaths, were reported in Madagascar.<ref>{{cite web |url=https://www.who.int/csr/don/02-october-2017-plague-madagascar/en/ |archive-url=https://web.archive.org/web/20171002195028/http://www.who.int/csr/don/02-october-2017-plague-madagascar/en/ |url-status=dead |archive-date=2 October 2017 |title=Plague – Madagascar Disease outbreak news|access-date=5 October 2017 }}</ref> The diagnosis was confirmed by the Institut Pasteur de Madagascar by a polymerase chain reaction test, while field health workers used a Rapid Diagnostic Test. The WHO and [[:fr:Institut Pasteur de Madagascar|Institut Pasteur de Madagascar]] were both involved in administering antibiotic compounds and attempting to stop the spread of the disease. By mid-October, there were an estimated 684 confirmed cases of plague with 474 pneumonic, 156 bubonic and one septicemic. The remainder were not classified. At least 74 deaths have been ascribed to pneumonic plague.<ref name="The Guardian">{{cite news |url=https://www.theguardian.com/global-development/2017/oct/19/madagascar-plague-death-toll-reaches-74 |title='It is a dangerous moment': Madagascar plague death toll reaches 74  |last=Beaumont |first=Peter  |date=19 October 2017 |work=The Guardian}}</ref>

The outbreak officially ended on 26 November 2017 with 2,348 cases and 202 deaths officially reported.<ref>{{cite web|title=WHO {{!}} Plague – Madagascar|url=https://www.who.int/csr/don/27-november-2017-plague-madagascar/en/|archive-url=https://web.archive.org/web/20171128164954/http://www.who.int/csr/don/27-november-2017-plague-madagascar/en/|url-status=dead|archive-date=28 November 2017|access-date=7 August 2020|website=WHO}}</ref>

===United States===
In the fall of 1924, an [[1924 Los Angeles pneumonic plague outbreak|outbreak occurred in Los Angeles]]<ref>{{cite book |doi=10.1016/B978-0-12-409527-4.00007-9 |chapter=Biology and Diseases of Other Rodents |title=Laboratory Animal Medicine |date=2015 |last1=Donnelly |first1=Thomas M. |last2=Bergin |first2=Ingrid |last3=Ihrig |first3=Melanie |pages=285–349 |isbn=978-0-12-409527-4 }}</ref> that killed 30 people.

On 2 November 2007, wildlife biologist Eric York died of pneumonic plague in [[Grand Canyon National Park]]. York was exposed to the bacteria while conducting a [[Autopsy|necropsy]] on a [[cougar]] carcass.<ref>{{cite web|url=https://www.usatoday.com/news/health/2008-10-21-plague-grand-canyon_N.htm|archive-url=https://web.archive.org/web/20120419094629/http://www.usatoday.com/news/health/2008-10-21-plague-grand-canyon_N.htm|url-status=dead|title=Plague emerges in Grand Canyon, kills biologist |website=USAToday.com|archive-date=19 April 2012}}</ref>

In 2014, the Colorado Department of Public Health and Environment confirmed that a Colorado man had been diagnosed with pneumonic plague, the first confirmed human case in Colorado in more than 10 years, and one of only 60 cases since 1957. The man was found to have the disease after the family dog died unexpectedly and a [[necropsy]] revealed that the disease was the cause.<ref>Coffman, Keith. [https://www.reuters.com/article/us-usa-colorado-plague/man-diagnosed-with-rare-pneumonic-plague-in-colorado-idUSKBN0FF01720140710 Man diagnosed with rare pneumonic plague in Colorado], Reuters (9 July 2014).</ref><ref>{{cite news|last=Kaplan|first=Sarah|title=A Colorado pit bull infected humans with the plague|newspaper=Washington Post|url=https://www.washingtonpost.com/news/morning-mix/wp/2015/05/01/a-colorado-pit-bull-infected-humans-with-the-plague/|access-date=21 September 2020|issn=0190-8286}}</ref> Three additional pneumonic plague cases were confirmed in Colorado before the outbreak ended.<ref>Basak, Sonali; Oldham, Jennifer. [https://www.bloomberg.com/news/2014-07-18/four-cases-of-life-threatening-plague-found-in-colorado.html Four Cases of Life-Threatening Plague Found in Colorado] {{webarchive|url=https://web.archive.org/web/20150114071830/http://www.bloomberg.com/news/2014-07-18/four-cases-of-life-threatening-plague-found-in-colorado.html |date=14 January 2015 }}, ''Bloomberg'', 19 July 2014. Accessed 4 November 2014.</ref>

==References==
{{Reflist}}

==External links==
{{Portal|Medicine}}
* {{commons category-inline}}
* [https://www.cdc.gov/plague/faq Frequently Asked Questions | Plague | CDC]. Centers for Disease Control and Prevention.

{{Medical resources
| ICD11           = {{ICD11|1B93.2}}
| ICD10           = {{ICD10|A20.2}}
}}

{{DEFAULTSORT:Pneumonic Plague}}
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