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Volume 26, Number 10—October 2020

Deaths Associated with Pneumonic Plague, 1946–2017

Alex P. Salam1, Amanda Rojek1, Erhui Cai, Mihaja Raberahona, and Peter HorbyComments to Author 
Author affiliations: United Kingdom Public Health Rapid Support Team, London, UK (A.P. Salam); Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK (A.P. Salam, E. Cai, M. Raberahona, P. Horby); Centre Hospitalier Befelatanana, Antananarivo, Madagascar (M. Raberahona); Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia (M. Raberahona)

Main Article


Sensitivity analysis of antimicrobial drug use and rates of pneumonic plague–related deaths, 1946–2017

Antimicrobial drug use Confirmed cases, % (95% CI) Total cases, % (95% CI)
Primary plague 27 (14–47) 6 (1–31)
28 (6–72)
6 (1–31)
Not treated
Primary plague 94 (82–98) 99 (22–100)
No data
Primary plague No data 29 (13–51)
Undifferentiated 42 (23–64) 51 (31–71)

*Crude analysis; model fails under this condition.

Main Article

1These co–first authors contributed equally to this article.

The death rate for persons with treated pneumonic plague is often reported as 50%, but firm evidence for this figure is minimal. We conducted a meta-analysis of articles reporting the death rate for persons treated for pneumonic plague. The rate was 17%, substantially lower than the frequently cited 50%.

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Page updated: September 17, 2020
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