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October 4, 2000

Safety Precautions to Limit Exposure From Plague-Infected Patients

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(13):1648-1649. doi:10.1001/jama.284.13.1647

To the Editor: Dr Ingelsby and colleagues1 recommend isolation of patients with pneumonic plague to prevent droplet (usually defined as particles larger than 5 µ) transmission. Isolation of this type only includes the use of surgical masks when standing within 1 m of the patient (because large droplets do not settle beyond 1 m of the patient) and no special ventilation systems.2 However, if airborne particles are aerosolized (ie, are smaller than 5 µ), then well-ventilated rooms under negative pressure and 95% efficient masks (class N95 respirators) would be required, as is the case for pulmonary tuberculosis.2

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