Plague

Risk factors:

The following conditions may increase the likelihood of a person contracting a plague infection.

o Living in a rural area and especially in areas where plague is common

o Having contact with sick animals, small rodents, or other possible hosts

o Participating in wilderness activities (such as camping, hiking, sleeping on the ground, hunting)

o Exposure to flea bites

o Exposure to naturally occurring plague in the community

o Employment as a veterinarian

o Outdoor activity during the summer months

Travel: Anyone who has traveled recently in the southwestern and Pacific Coast regions of the US, particularly in New Mexico, Arizona, California, and Utah, might have had a flea bite.

Animal contact: Close contact with infected animals and travel through rural areas are risk factors for contracting plague.

Signs and Symptoms:

Common general symptoms

Fever

Chills

Body aches

Sore throat

Headache

Weakness

General feeling of illness

Abdominal pain (may be the only symptom for someone with septicemic plague)

Nausea, vomiting (sometimes containing blood)

Constipation, diarrhea, and black or tarry stools

Stomach pains

Cough (may contain blood)

Shortness of breath

Stiff neck

Fever, heart irregularities, low blood pressure

Confusion, seizures (later in the infection period)

Diagnosis:

In making the diagnosis, a doctor performs certain blood tests such as cultures (growing the bacteria in the lab from samples of blood,sputum, and fluid from the bubo). Cultures require more than 48 hours to produce definitive results.

A doctor may order an x-ray film of the chest, especially to see if plague has infected the lungs.

The Centers for Disease Control and Prevention (CDC) may test samples with more sophisticated procedures. Typically, the CDC and the local Department of Health attempt to identify the source of the plague and begin procedures for preventing a potential plague epidemic.

Treatment:

Patients are isolated and all precautions taken not to infect others. Some patients may need help breathing and are given oxygen. They are kept away from others for 2-3 days after antibiotic treatment has started or until the infection is cleared.

Most patients experience some degree of septic shock (blood infection/poisoning), and specialists monitor this closely in an intensive care unit.

Medical management of plague can involve a number of medications. Antibiotics must be given early. These might include streptomycin sulfate in combination with tetracycline and other antibiotics.

Suspected pneumonic plague cases