17782 Plague

Overview

Plague is a rare but serious bacterial infection caused by Yersinia pestis. It has been around for centuries and is still found in some parts of the world today. With quick medical care, it can be treated successfully.

Plague is very rare in most countries. A few thousand cases are reported worldwide each year.

It can affect anyone, but people in rural areas, hunters, hikers, and those who handle animal blood or tissue are more at risk.

Symptoms

Common symptoms

• High fever and chills
• Headache and extreme tiredness
• Swollen, painful lymph nodes (called buboes)
• Nausea, vomiting, and stomach pain
• Cough with chest pain (especially with pneumonic plague)
• Bleeding under the skin or from the mouth, nose, or rectum (in septicemic plague)

Symptoms in children

• Kids may have the same symptoms as adults, but they can get sick very quickly.
• Young children might not be able to say where it hurts, so watch for irritability, tiredness, or a swollen lump.

Symptoms in older adults

• Older adults may have a higher fever and more confusion.
• They are more likely to develop severe complications like breathing trouble.

Causes

Main causes

• Bacterial infection with Yersinia pestis
• Bites from infected fleas, usually from rats or other rodents
• Direct contact with blood or tissue of an infected animal
• Breathing in droplets from a person or animal with pneumonic plague

Risk factors

• Living in or visiting rural areas where plague is found in animals
• Hunting, camping, or handling wild animals
• Having a job that involves contact with animals, like a veterinarian or wildlife worker
• Living in crowded housing with poor sanitation

When to see a doctor

See a doctor urgently if:

• If you have a sudden fever and swollen lymph nodes and you have been in a place where plague occurs
• If you have a fever and cough, especially if you may have been exposed to plague

Book a routine appointment if:

• If you have had contact with a sick or dead animal and you are worried about your risk

Diagnosis

A doctor will ask about your symptoms and any possible exposure to animals or fleas. They will check your body for a swollen lymph node and signs of infection.

Tests that may be done

• Blood tests to look for the bacteria
• Samples from the swollen lymph node, sputum, or fluid around the lungs
• Chest X-ray if a lung infection is suspected

What to expect at your appointment

If plague is suspected, you will likely be treated with antibiotics right away, even before test results come back. Treatment is most effective when started early.

Treatment

Plague is treated with antibiotic medicines, which can easily cure the infection if started quickly. For severe forms, you may need care in a hospital, including oxygen or fluids. People with pneumonic plague are kept isolated so the infection does not spread.

Self-care at home

• Follow your healthcare team’s advice completely
• Take all medicines exactly as prescribed, even if you feel better
• Rest and drink fluids to stay hydrated
• Use simple pain relief for fever only if your doctor approves

Medical treatments

Antibiotics are the main treatment. Your doctor will choose the right one based on your age, health, and the form of plague. In the hospital you may also receive oxygen, IV fluids, and medicines to control fever. There is no specific role for surgery; sometimes surgery is needed to drain a swollen lymph node or remove dead tissue in severe septicemic cases.

When is surgery considered?

In rare, severe cases, a doctor may need to drain a painful bubo or remove damaged tissue. This is decided by specialists if needed.

Living with this condition

During treatment, rest is key. If you have pneumonic plague, you will be isolated until you are no longer contagious. Keep in contact with your care team as they guide you home.

Lifestyle tips

• Take all medicines without missing a dose
• Keep wounds clean and covered if you have any skin issues
• Avoid close contact with others while you are contagious (if you have pneumonic plague)

Diet and exercise

Eat a balanced diet to help your body recover. Start with light activity as you feel able, and gradually build up your strength. Follow your doctor's advice about when to return to normal exercise.

Mental health and emotional wellbeing

A serious infection can be frightening. It is normal to feel anxious or worried. Talk to your doctor or a trusted counselor if you need emotional support. Lean on friends and family for comfort.

Prevention

Yes, you can reduce your risk by avoiding contact with wild rodents and fleas. Use insect repellent, wear long sleeves and pants in areas where plague is present, and keep your home and campsite free of rodents.

Vaccines

There is a vaccine for plague, but it is not widely available or recommended for most people. Your doctor can tell you if it is needed for your situation, such as for some laboratory or field workers.

Screening programmes

Routine screening is not done for plague. Prevention focuses on avoiding exposure and seeking care early if symptoms develop.

Complications

If left untreated

• Untreated bubonic plague can spread through the bloodstream and become septicemic plague
• It can cause shock, gangrene, or meningitis (swelling of the brain and spinal cord)
• Pneumonic plague can cause respiratory failure and is often fatal if not treated quickly

Long-term outlook

With early treatment, most people recover fully. The outlook is very good when antibiotics are started within the first day of symptoms. Even severe cases can be cured with prompt hospital care. Do not wait if you are worried – seek medical help right away.

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