What You Should Know about Plague

Plague is transmitted by fleas that become infected with bacteria Yersinia pestis.

Infection can also take place through exposure to infected animals if they coughed and spread the infectious droplets or through a break in the skin while dealing with infected animal.

Infection usually starts with flu-like symptoms, in which the patient experiences fever, chills, weakness, nausea and vomiting.

Types of Plague

Clinical plague has three forms according to the route of infection:

1) Bubonic Plague

It is the most common type of plague. After the person is bitten, the bacteria travel through the lymphatic system, infecting the nearest lymph node, and replicate in high numbers.

The enlarged lymph node is called "bubo"; it is usually swollen, warm, and painful. In advanced cases, the bubo can become suppurated. Other symptoms include fever and chills, headache, fatigue, and muscle aches.

2) Septicemic Plague

Septicemic plague occurs when plague bacteria multiply in the bloodstream. It results from flea bites or contact with infection through skin cracks. It might also occur as a complication of bubonic plague.

Signs and symptoms include abdominal pain, diarrhea and vomiting, fever and chills, bleeding from nose, mouth, or rectum, shock, gangrene (blackening and death of tissue) in the extremities (Mayo Clinic)

3) Pneumonic Plague

It is the least common type of plague yet the most virulent and fatal. It can be primary which occurs by inhaling infectious droplets, or seconadary as a complication of advanced cases of bubonic form.

Signs and symptoms include high fever, nausea, vomiting, weakness, chest pain, difficulty breathing, and cough with bloody sputum. (Mayo Clinic)

Could it spread from one person to another?

In case of pneumonic plague, infection spreads from the infected person's cough droplets when breathed by non-infected ones.

Can plague be cured?

Rapid diagnosis and treatment is very important in this case. If treated effectively, and diagnosed in time, plague patients can be cured. (WHO)

The person diagnosed with plague should be isolated and hospitalized. The treatment  includes:

Medications

The patient is given strong antibiotics intravenous or intramuscular. Streptomycin and Gentamycin are the most effective. Tetracycline, Chloramphenicol, and Vibramycin are other alternatives.

Supportive Therapy

In case of patients with complications like bleeding or respiratory distress, they are given respiratory support, intravenous fluids, and oxygen.

Prevention

People should be aware and take precautions against flea bites and handling carcass in endemic areas. They should avoid direct contact with pneumonic plague patients and direct contact with infective tissues.

Who are at high risk of being exposed to plague?

• Those who have close contact with infected person or animal
• Bitten by a flea in a place known to have plague cases recently
• Going to a place with recent plague outbreak

What should people in high risk areas do?

• Avoid contact with sick person or animal
• Rodent-proof their homes
• Use flea control products with their pets

Sources:

“Plague.” World Health Organization. Accessed 24 June 2009.

“Questions and Answers About Plague.” Centers for Disease Control and Prevention. Accessed 24 June, 2009.

“Plague.” Mayoclinic. Accessed 24 June, 2009.