Skip to main content
    • Aa
    • Aa

Transmission dynamics of primary pneumonic plague in the USA

  • A. F. HINCKLEY (a1), B. J. BIGGERSTAFF (a1), K. S. GRIFFITH (a1) and P. S. MEAD (a1)

Plague is thought to have killed millions during three catastrophic pandemics. Primary pneumonic plague, the most severe form of the disease, is transmissible from person-to-person and has the potential for propagating epidemics. Efforts to quantify its transmission potential have relied on published data from large outbreaks, an approach that artificially inflates the basic reproductive number (R0) and skews the distribution of individual infectiousness. Using data for all primary pneumonic plague cases reported in the USA from 1900 to 2009, we determined that the majority of cases will fail to transmit, even in the absence of antimicrobial treatment or prophylaxis. Nevertheless, potential for sustained outbreaks still exists due to superspreading events. These findings challenge current concepts regarding primary pneumonic plague transmission.

Corresponding author
*Author for correspondence: Dr A. F. Hinckley, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3. LD Rotz , Public health assessment of potential biological terrorism agents. Emerging Infectious Diseases 2002; 8: 225230.

7. RM Anderson , RM May . Infectious Diseases of Humans: Dynamics and Control. London: Oxford University Press, 1991.

10. M Lipsitch , Transmission dynamics and control of severe acute respiratory syndrome. Science 2003; 300: 19661970.

11. JO Lloyd-Smith , Superspreading and the effect of individual variation on disease emergence. Nature 2005; 438: 355359.

12. S Riley , Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions. Science 2003; 300: 19611966.

14. Z Shen , Superspreading SARS events, Beijing, 2003. Emerging Infectious Diseases 2004; 10: 256260.

15. R Gani , S Leach . Epidemiologic determinants for modeling pneumonic plague outbreaks. Emerging Infectious Diseases 2004; 10: 608614.

20. WH Kellogg . An epidemic of pneumonic plague. American Journal of Public Health (New York, NY) 1920; 10: 599605.

24. C Dye , N Gay . Epidemiology. Modeling the SARS epidemic. Science 2003; 300: 18841885.

28. G Morelli , Yersinia pestis genome sequencing identifies patterns of global phylogenetic diversity. Nature Genetics 2010 42: 11401143.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 2
Total number of PDF views: 25 *
Loading metrics...

Abstract views

Total abstract views: 210 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd September 2017. This data will be updated every 24 hours.