Information on infectiousness of human corpses can guide development of protective measures for healthcare staff and relatives who might not use PPE during traditional funeral rituals ( 14). Little is known about the potential infectiousness of corpses, the duration of risk for infection to humans handling corpses, or possible transmission routes. To inform World Health Organization recommendations on personal protective equipment (PPE) for healthcare workers, we evaluated whether corpses of plague patients might be infectious. Orange arrows indicate causality of different plague syndromes according to transmission routes. Black arrows indicate links between infection sources and transmission routes. Reservoirs of Yersinia pestis and transmission routes leading to different forms of plague. Plague has 3 main clinical syndromes: bubonic plague, which is characterized by inflammation of lymph nodes after a flea bite or scratch from an infected animal ( 11, 12) pneumonic plague, which is spread by inhalation of droplets from infected humans or animals and septicemic plague, which results from the hematogenous spread of bubonic or pneumonic plague ( 13). pestis through bites from infected fleas or animals, handling or ingesting infected animals or humans, or inhaling aerosolized droplets from infected tissues ( Figure 1) ( 6– 10). Caused by Yersinia pestis, a nonmotile, gram-negative coccobacillus, this zoonotic disease has its main reservoir in rodents ( 4, 5). Plague remains a threat in many parts of the world ( 2) and has been categorized by the World Health Organization as a reemerging disease ( 3). Plague is an ancient disease that has killed millions of persons including one third of the population of Europe during the Black Death pandemic in the 14th century ( 1).
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