“Pneumonic plague had come to my hospital”
A junior doctor in Africa encounters one of the most deadly infectious diseases
A young woman coughing up blood on a busy medical ward in an African hospital is nothing out of the ordinary. “Its probably just tuberculosis,” I thought. “Let’s send some sputum for AAFB [no acid; alcohol fast bacilli test],” I said to the nurses.
However, this case of haemoptysis wasn’t quite as simple as I first imagined. I soon found out that this woman had been admitted after her 5 year old son had died earlier that day on the paediatric ward from an unknown febrile illness. There were also reports that the village she lived in had also seen febrile illnesses and deaths.
I mentioned this case to one of my Ugandan colleagues who suggested the possibility of a viral haemorrhagic fever or possibly pneumonic plague. We quickly put her in an isolation room, collected a sputum sample, and called for the laboratory technician to do a rapid antigen