Plague
Plague is a bacterial disease caused by fleas and carried by rats, or other small animals like rabbits, squirrels, cats or prairie dogs, to the human population. It is an extremely serious, life-threatening illness. Although often associated with the specific epidemic that wiped out millions of people in Europe during the Middle Ages, plague still infects people today. Recent cases can be found in Africa, Asia and South America. While plague is rare in the United States, it has been known to infect individuals in some western states.
Types of Plague
There are three types of plague: bubonic, pneumonic and septicemic. Typically, the plague known in recent times is spread by the bites of infected rodents, or, in rare cases, from a small scratch by an infected animal. There is, however, some scientific evidence that the Black Death may actually have been pneumonic, rather than bubonic plague. It is speculated that unless the disease had been contagious through airborne transmission, it could not possibly have decimated such a large population so quickly.
Bubonic Plague
Bubonic plague is an infection of the lymph nodes. Its symptoms typically appear suddenly, about 2 to 5 days after exposure. The symptoms of bubonic plague include:
- Headache
- Chills and fever
- Malaise
- Muscle pain
- Seizures.
Pain in one or more lymph nodes, followed by the telltale swelling known as a bubo, can develop in the groin, armpit or neck.
Pneumonic Plague
Pneumonic plague is an infection of the lungs. It is contagious through the air. The cough or sneeze of an infected patient can easily infect others who are nearby so this infection is extremely contagious.
The symptoms of pneumonic plague include:
- Severe coughing
- Difficulty breathing
- Fever
- Frothy, bloody sputum
- Chest pain during respiration
These symptoms have a sudden onset, usually 2 to 3 days after exposure, though a person can incubate and become ill with the disease in as little as a day.
Septicemic Plague
Septicemic plague is a bacterial infection of the blood. It is extremely dangerous and may result in death before the patient has experienced any symptoms. When the patient does experience symptoms, they may include:
- Abdominal pain
- Bleeding (blood-clotting difficulty)
- Fever
- Nausea and vomiting
- Diarrhea
While septicemic plague represents a severe systemic infection, it does not appear to be contagious from direct contact with an infected person.
Diagnosis of Plague
Several tests are performed to make a definitive diagnosis of plague. These include a blood culture, an aspiration and culture of fluid from an infected lymph node (bubo), and a sputum culture. When plague is suspected, taking a medical history is important to determine whether the patient has had contact with rats or other small mammals or with other individuals who handle such creatures.
Treatment of Plague
Rapid diagnosis and treatment of plague is essential. Without treatment, approximately 50 percent of bubonic plague patients, and almost 100 percent of pneumonic plague patients, will die. Strong antibiotics, such as streptomycin, gentamicin, doxycycline, or ciprofloxacin are used to treat the disease. In addition, oxygen, other respiratory therapy, and intravenous fluids are administered.
Patients with pneumonic plague have to be kept in strict isolation in order to protect family members, healthcare workers and other patients. Anyone known to have been exposed to a patient with the disease is observed carefully and often give prophylactic antibiotics.