Plague (Pestis)

Plague is an infection caused by the bacteria Yersinia pestis, and is an illness that dates from antiquity; manifested commonly by swollen lymph glands with fever, chills, but can also lead to severe pneumonia, meningitis, shock and death.

The bacteria are common in rats and the fleas that affect them.

Where does it occur?

Plague bacteria is seen among wild rats in large areas of Western USA, Canada, Africa, Middle East, Central, South and East Asia as well as Southern Europe close to the Caspian Sea, Northern South America and Central America. In addition, it is carried by squirrels, prairie dogs, mice, bobcats, wild cats, rabbits and chipmunks. (Map)

How is it transmitted?

It is most commonly transmitted through the bite of infected fleas. One can also acquire it by handling tissue of infected animals or by inhalation of bacteria spread by the cough from those ill with pneumonia and sore throat.

Is it contagious from person to person?

It is contagious from person to person by inhaling bacteria through the oral secretion of an ill person who is coughing.

What is the risk for travelers?

The risk is generally low for travelers.

How soon after exposure will I develop symptoms?

Symptoms usually develop within 1-7 days after exposure.

What are the signs and symptoms?

The most common manifestation of plague is called bubonic plague: presenting with sudden fever, chills, sweats, fatigue, headache and swollen intensely painful lymph nodes in the groin, arm pit or neck. One may also see skin lesions of small pimples, boils and gangrene as well. The pain can be severe enough to encourage an individual to keep the affected limb as still as possible.

As the bacteria spreads through the bloodstream to the lung one can see cough, shortness of breath, chest pain and coughing up of blood; this syndrome is called pneumonic plague.

Plague infection can also spread to the central nervous system causing fever, headache, stiff neck, confusion and coma; this syndrome is called meningitis plague.

In severe cases the blood infection is overwhelming and leads to multi organ failure causing shock leading to death; this syndrome is called septic plague.

Is there any treatment?

Antibiotics like streptomycin, tetracycline, and chloramphenicol are effective.

Are there any lab tests to diagnose illness?

Bacteria can be seen in body secretions like blood, sputum, pus or spinal fluid under the microscope and cultured in the laboratory. Blood antibody tests are also available.

What preventive measures can be taken?

Avoid staying in primitive accommodations, do not handle dead animals, avoid exploring areas of rat burrows, and use insect safety measures.

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