SIMPLE TEST FOUND TO QUICKLY SPOT PLAGUE INFECTION



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Last Updated

17 Jan 2003

Source: Reuters, January 17, 2003

Simple Test Found to Quickly Spot Plague Infection

NEW YORK (Reuters Health) - A simple dipstick test can quickly diagnosis plague, a sometimes-fatal bacterial infection thought to be a potential bioterror weapon, according to a report out Thursday.

Because plague pneumonia, the most severe form of the infection, is fatal unless promptly treated, a rapid test for the disease could cut deaths and the odds of transmission among people.

And since the world regions where plague remains endemic are mainly rural and remote, a cheap, on-the-spot test is sorely needed.

According to researchers, the new bedside test, tried out at 26 sites in Madagascar, has proven at least as effective as standard lab tests for plague.

The findings appear in the January 18th issue of The Lancet.

Plague is a disease of rodents that can be passed to humans by infected fleas or, occasionally, contact with infected animal tissue. Only in its pneumonic form can it be transmitted from person to person through the air.

Plague epidemics were once responsible for the deaths of millions, including the "Black Death" that wiped out a third of Europe's population and killed millions in Asia.

Today, the World Health Organization reports 1,000 to 3,000 cases of plague globally every year, most often in Africa. Sporadic cases still occur in the US.

Plague can take three forms -- bubonic plague, which caused the black swellings, or buboes, that gave the Black Death its name; pneumonic plague, which is far deadlier; and septicemic plague, a rare blood infection.

Plague is considered a possible bioterrorist agent because it is easy to prepare and use as a weapon. It is also easily treated with antibiotics, however, if diagnosed properly.

Experts hope that the new test will help in this. The test has been distributed to health centers in Madagascar -- the nation that has been hardest-hit by the plague in the past decade -- and it's expected to soon reach plague-endemic areas worldwide.

In the pilot study, Dr. Suzanne Chanteau of the Institut Pasteur de Madagascar and her colleagues found that, within 15 minutes, the test detected low levels of an antigen found on plague bacteria.

In addition, they report, the test also seems to reliably catch pneumonic plague, which could allow more patients to get much-needed rapid treatment.

"These measures should, in turn, help to prevent the spread of pneumonic plague in endemic countries or in cases of bioterrorist use," the researchers write.

Researchers at the US Centers for Disease Control and Prevention describe the study as "remarkable" in an editorial published with the report.

According to Drs. David T. Dennis and May C. Chu, the test "is expected to fill an important need in bioterrorism preparedness and response."

SOURCE: The Lancet 2003;361:211-216,191.