The use of standard precautions is appropriate for managing
plague patients who do not have respiratory infections.
In past epidemics, patient-to-patient transmission only seemed
to occur after close contact, often for prolonged periods, with
a patient that coughed bloody sputum. It is extremely rare for
patients in the early stage of pneumonic plague to transmit
the infection to others.
Bubonic: Standard and contact precautions if any open wounds.
Pneumonic: Standard and respiratory droplet precautions.
(Note: Available evidence indicates that person-to-person
spread of pneumonic plague is via respiratory droplets, not
fine aerosols or droplet nuclei.)
Septicemic: Standard precautions.
Pneumonic plague patients are no longer infective after 24
to 48 hours of antibiotic treatment, because the sputum no longer
contains live bacilli. However, they may still be ill and continue
demonstrating signs of pneumonia.