Plague

What is it?

Plague (playg) is a disease caused by a bacteria (bak-TEER-e-uh) called Yersinia (yur-SIN-e-uh) pestis. It is a rodent disease. Plague is found in rodents in North and South America, Europe, Africa, and Asia. Examples of rodents that carry plague are rats, prairie dogs, and squirrels. In the United States, plague is found in dry rural areas. New Mexico, Utah, Colorado, Arizona and parts of California have all reported plague-infested rodents.

How do people get plague?

People can get plague from fleas that jump off an infected rodent and bite them. Sometimes people get plague from another person who has the plague. There are 3 kinds of plague:

• Bubonic plague causes large painful lumps called "buboes" (BOO-bows).
  
  
• Systemic plague is when plague bacteria gets into the blood.
  
  
• Pneumonic plague is a lung infection caused by the plague bacteria. Once the bacteria is in the lungs, it can be spread from person to person by coughing or sneezing.

What are the symptoms of plague?

• Bubonic plague symptoms begin 2 to 8 days after being bitten by a flea carrying the bacteria. Symptoms begin suddenly with a fever, chills and weakness. About one day later, a lymph node becomes very painful. Lymph nodes are in the armpit, the neck, or the groin—the area where the upper leg and the abdomen meet. The swollen, red, and extremely painful lymph node is called a bubo. A bubo may be one half inch to 4 inches (1-10 cm) across. Rarely, the bubo opens up and pus comes out. Little pus areas or skin sores may show up where the flea bit the person.
  
  
• Systemic plague is plague in the blood. The symptoms of systemic plague are nausea, vomiting, diarrhea, belly pain, and bleeding. Other symptoms are skin patches that turn purple, and patches of skin that become black because the blood vessels that bring them oxygen die.
  
  
• Pneumonic plague is like pneumonia. The symptoms are chest pain, painful breathing, and coughing up blood.

How is plague diagnosed?

Caregivers may not be sure a person has plague for a long time. The only way to be sure is to grow a culture. A blood, phlegm (flem) (the stuff coughed up from lungs), or a bubo sample is taken. The sample is smeared in a special culture dish. Plague grows so slowly in a culture that an infected person can die before the diagnosis is made. Caregivers must make a diagnosis quickly because plague kills quickly. Usually a diagnosis is made because of these two reasons:

• Where the person was in the last week to 10 days. The sick person was in an area where rodents are known to have plague.
  
  
• The person is very sick. The person is sicker than they would be with regular pneumonia or flu, for example.

What should I do if am exposed to plague?

If you have been exposed to plague, seek medical care immediately. There are antibiotics (an-ti-bi-AH-tiks) available that will keep you from getting plague. If you already have plague and are in the very early stages, plague can often be cured.

What is the risk of a plague outbreak?

• About 1700 people worldwide get plague every year. The last case of natural human-to-human plague happened in the US in Los Angeles in 1924.
  
  
• During the 1950’s and 1960’s both the United States and the Soviet Union experimented with plague in aerosol (spray) form and also in weapon delivery. Plague germs will live for about an hour in the open. The type of plague people would get from aerosols or weapons is pneumonic plague.
  
  
• In case of a biological attack, it would take between 1 and 6 days to show symptoms of pneumonic plague. The usual time is 2 to 4 days. The earliest symptoms would be fever with a cough and painful breathing. Sometimes phlegm would be bloody or have pus. Other symptoms may be nausea, vomiting, and diarrhea.

Where can I get more information about plague?

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 404 - 6393311
  Phone: 1- 800 - 3113435
  Web Address: http://www.cdc.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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