Plague

Plague is an infectious disease caused by the bacterium Yersinia pestis. There are two main clinical forms of plague infection: bubonic and pneumonic. It can be a very severe disease in humans. While bubonic plague has a mortality rate of 30% to 60%, pneumonic plague is almost always fatal when left untreated.

Signs and symptoms

Patients infected with plague usually develop non-specific symptoms such as fever, chills, muscle pain, weakness, headache, nausea and vomiting. Symptoms occur 1 to 7 days after exposure.

Bubonic plague, which is the most common form of plague, is characterized by painful inflammation of the lymph nodes, called "buboes". Inflamed lymph nodes can turn into open sores filled with contagious fluid. Pneumonic plague, while quite rare, is extremely severe, and is characterized by coughing and shortness of breath.

Transmission

Plague is a bacterial infection usually found in small mammals and their fleas. Household pets can also bring infected fleas into the home. Humans can be infected through:

  • The bite of infected fleas
  • Unprotected contact with infectious bodily fluids (carcass of an infected animal, fluid from an ulcerated bubo)
  • Inhalation of airborne droplets from a patient with pneumonic plague released through coughing or sneezing
  • Contact with bedding or clothing contaminated with infected body fluids

Prevention

Preventive measures include finding out if plague is present in the area you are travelling to. If so, it is advised to take precautions against flea bites (by wearing light-coloured long pants and long sleeves and using insect repellents containing DEET or icaridin), and avoiding contact with wild animals, whether alive or dead, particularly rodents. Additional precautions must be used if pneumonic plague is present in humans, since it is extremely contagious. Speak to your healthcare provider.

Vaccination is recommended for high-risk groups only (e.g., health care workers exposed to the disease).

Treatment

Urgent medical attention is advised in individuals who develop fever or any other related symptom that occurs within 10 days of possible exposure to plague. Treatment involves the use of antibiotics.

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