The Return of the Plague?

When you think of the plague, you probably think of the notorious epidemic that swept the Middle Ages. What comes to mind may be dirty cities overrun by rats, swollen lymph glands, and so-called “doctors” dressed in bird beak masks stuffed with herbs that were supposed to “ward off” the plague. You may think that the plague is a nightmare of the past, but in some corners of the world, it’s still alive and well, which means we should all be aware of its characteristics and capabilities.

But what exactly is a plague? And how is it still plaguing us?

Three Types of Plague

Plague is a disease caused by the bacterium Yersinia pestis, and it can affect both humans and animals. Usually, humans contract plague after being bitten by a flea carrying the disease. There are three main forms of the disease.

Bubonic Plague

Patients typically get bubonic plague from being bitten by a flea carrying the bacteria. Symptoms of bubonic plague include sudden fever, headache, weakness, and chills. The lymph nodes swell into painful “buboes.” Bubonic plague cannot be spread from human to human.

Septicemic Plague

Septicemic plague may result in fever, chills, weakness, abdominal pain, and bleeding in the skin and other organs. Body parts can turn gangrenous and tissues can die, resulting in missing parts like fingers. Septicemic plague is also transmitted by fleas.

Pneumonic Plague

Pneumonic plague is the most serious form of plague. Symptoms include fever, weakness, headache, and pneumonia. Respiratory failure and shock are also possibilities. Pneumonic plague is the only form of plague that can be transmitted from human to human through respiratory droplets.

Treating Plague

Plague is treatable if treatment begins early. Antibiotics like Avelox® (moxifloxacin) can work against the plague. However, plague should be treated as a very severe disease. Pneumonic plague, in particular, is always fatal if left untreated. Victims of pneumonic plague can even die within 18-24 hours of onset if they don’t get treatment. Therefore, it’s important to find help as soon as possible if you suspect you may have been exposed to plague.

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The Black Death

The plague has been a powerful force in history. Some historians even think the plague was partly responsible for the fall of the Roman Empire. There have so far been three major plague pandemics, the second of which is the infamous Black Death. Originating in China and spreading to Europe via trade routes, the Black Death wiped out an estimated 60% of the European population. Lack of sanitation and knowledge about diseases likely didn't help!

Two other major historical plagues were the Justinian Plague in the Mediterranean area that began in 541 AD and the Modern Plague, which began in China in the 1860s and spread to port cities worldwide.

The Plague Today

Over 95% of today’s plague cases occur in sub-Saharan Africa and Madagascar. In Madagascar, about 200-700 cases are reported every year. In 2017, an unusually large epidemic occurred in the island African nation, with particularly high incidences of pneumonia cases. This epidemic circulated predominantly in two major urban areas.

Plague in the United States is more common in rural areas and in the southwest, primarily New Mexico, Colorado, and Arizona. People that live near wild rodent populations and hunters are at greatest risk in the United States. More than 80% of U.S. plague cases are the bubonic form, which is less dangerous than the pneumonic form.

Preventing Plague

Unfortunately, there is no vaccine yet to treat the plague, though one is in the works. Meanwhile, common-sense prevention methods like the following are your best chances at avoiding plague:

• Manage rodent populations in areas you frequent (home, office, etc.).
• Wear gloves when handling dead animals.
• Use bug repellent when doing outdoor activities.
• Make sure your pets are free of fleas. Free-roaming animals, such as outdoor cats, are at greater risk of getting infected.
• Avoid contact with animals that roam freely in endemic areas.

If you believe you have been exposed to the plague, find help immediately. Antibiotic treatment for seven days will help most people defend against the disease if they have been exposed.

The plague may seem like a scary disease, but remember, it is treatable by modern medicine as long as you seek care in a timely fashion.