Reporting & Investigation of Plague

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify potential sources of transmission in the United States (such as wild rodents or other animals).
  • To identify sources of transmission and geographical areas of risk outside of the United States.
  • To stop transmission from such sources.
  • To identify cases and clusters of human illness that may be associated with a bioterrorist event.
  • To assess appropriate treatment.

B. Laboratory and Healthcare Provider Reporting Requirement

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider immediately report any suspected or confirmed case. Report any suspicion of plague called to your attention by a healthcare provider or any positive laboratory result pertaining to plague. Also, report any potential exposure to plague that may be the result of bioterrorism. The reporting number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736. If after business hours, call IDPH at the same number and instructions will be given on how to reach on-call staff.

Laboratory Testing Services Available

The University of Iowa State Hygienic Laboratory (SHL) provides services for testing clinical specimens for Yersinia pestis and for confirmation of isolates from sentinel laboratories. Sentinel laboratories can send specimens (blood, tissue biopsies, discharge fluid, vesicle fluid, etc.) to SHL.  Isolates submitted from other laboratories will be confirmed and/or identified. Additionally, SHL requests that all laboratories submit all isolates cultured for further identification as rapidly as possible, to aid in the public health surveillance necessary for this illness.  SHL needs to be contacted before samples are submitted. For more information on submitting samples, contact SHL at 319-335-4500.

C. Local Public Health Agency (LPHA) Follow-up Responsibilities

Case Investigation

  1. The most important thing an LPHA can do if it learns of a suspect or confirmed case of plague, or a potential exposure that may be a bioterrorism event, is to immediately call IDPH, any time of the day or night. The number for the 24-hour disease reporting hotline is (800) 362-2736.

  2. Case investigation of plague in Iowa residents will be directed by IDPH Center for Acute Disease Epidemiology. If a bioterrorism event is suspected, IDPH and other authorities will work closely with the local public health agency and provide instructions and information on how to proceed.

  3. The local public health agency may asked to assist in investigating cases that live within their communities, including gathering the following:

    • The case’s name, age, address, phone number, status (hospitalized, at home, deceased), and parent/guardian information, if applicable.

    • The name and phone number of the hospital where the case is or was hospitalized.

    • The name and phone number of the case’s attending physician.

    • The name and phone number of the infection-control official at the hospital.

    • The names and phone numbers of patients seen by a healthcare provider before hospitalization or of other hospitals if seen at more than one hospital.  

  4. Disease control is an integral part of case investigation. It is the LPHA responsibility to understand, and, if necessary, institute the control guidelines listed in Controlling Spread.