TAILIEUCHUNG - Morbidity and Mortality Weekly Report: Imported Plague — New York City, 2002

Intuitively, a simple event notification service that provides no selection mechanism can be reduced to a multicast routing and transport mechanism for which there are numerous scalable implementations. However, once the service provides a selection mechanism, then the overall efficiency of the ser- vice and its routing of notifications are affected by the power of the language used to construct notifications and to express filters and patterns. As the power of the language increases, so does the complexity of the processing. Thus, in practice, scalability and expressiveness are two conflicting goals that must be traded off | MMWR Morbidity and Mortality Weekly Report Weekly August 8 2003 Vol. 52 No. 31 Imported Plague New York City 2002 On November 1 2002 a married couple traveled from Santa Fe County New Mexico to New York City NYC where they both became ill with fever and unilateral inguinal adenopathy bubonic plague Yersiniapestis was diagnosed subsequently. This report summarizes the clinical and public health investigation of these cases and underscores the importance of rapid diagnosis and communication among health-care providers public health agencies and the public when patients seek medical attention for an illness that might be caused by an agent of terrorism. Case Reports Case 1. On November 5 a man aged 53 years sought medical care in a NYC emergency department ED after consulting with his physician in New Mexico and the physician at the hotel in which he was staying. He reported 2 days of fever fatigue and painful unilateral inguinal swelling. On clinical examination he appeared ill with diaphoresis rigors and lower extremity cyanosis. His temperature was F C blood pressure was 78 50 mm Hg and oxygen saturation was 98 on room air. He had tender left inguinal adenopathy with overlying edema. White blood cell WBC count was 24 700 L normal 4 300-10 800 L and platelet count was 72 000 L normal 130 000-400 000 L . A blood culture grew Y. pestis. Gram stain of the blood culture isolate revealed bipolar gram-negative rods with a safety pin appearance. On November 6 direct fluorescent antibody DFA to F1 antigen and polymerase chain reaction PCR performed on the initial blood culture conducted by the NYC Public Health Laboratory NYCPHL both were positive. The patient received gentamicin doxycycline ciprofloxacin vancomycin and activated protein C. The patient s condition deteriorated and he was admitted to the intensive care unit ICU in shock with a diagnosis of septicemic plague acute renal failure acute respiratory distress syndrome and disseminated .

• Tổ chức sự kiện
• Endometriosis
• Abdominopelvic Complications
• Complications of Endometriosis
• Diagnostics and Treatment
• Pathological Aspects
• Aspects of Endometriosis
• Urinary Tract Endometriosis
• Diagnosis and Treatment
• Perineal Endometriosis