Plague (Yersina pestis infection) Plague is an acute, highly contagious infectious disease associated with severe symptoms. The cause of the plague is the bacterium Yersinia pestis, which is transmitted to humans by rodents. Plague is Latin (pestis) and means plague. The disease used to occur in pandemics. Affected large parts of the world population the last major pandemic was in 14. recorded in the twentieth century. At that time one spoke also of the ''black death'', for which probably the bacterium Yersinia pestis was responsible, although also other causes (z.B. the anthrax) can be discussed.
Even today, large epidemics continue to occur in parts of Africa, Southeast Asia, and South and North America. No plague activity is currently suspected in Europe.
For some forms of plague there is a vaccination, but it is only effective for a few months and is only conditionally recommended because of the strong side effects. For other forms there is no vaccination. Here, only hygienic measures as well as isolation (quarantine) of affected persons from plague infection can provide some protection.
Antibiotics are highly effective against the plague, if they are administered to the patient early and not only in the advanced stage of the disease. Untreated, the plague leads to death.
The disease is notifiable and affected persons must be quarantined, d.h. be transferred to special infectious wards.
The bacterium Yersinia pestis is z.B. transmitted to humans by marmots, rats, squirrels or infected fleas. People who work in the forest are therefore at greater risk of contracting infection.
There are four different forms of plague:
– bubonic plague – plague sepsis – pneumonic plague – abortive plague
In pandemics, all four forms usually occur together, but bubonic plague and pneumonic plague are the most common.
Infection usually occurs via a bite from the rat flea. Typical of the bubonic plague are the ca. 4 cm swellings (bumps) on the neck, in the armpit and in the groins. These are caused by infection of the lymph nodes and lymph vessels. If left untreated, the pathogen spreads throughout the body via the bloodstream, causing plague sepsis as well as infestation of other organs (z.B. lungs or skin) can lead. If left untreated, bubonic plague leads to death in almost most cases.
It occurs when the pathogens enter the bloodstream. This happens through open wounds or as a complication of bubonic plague, when the swellings burst inwards. If left untreated, the affected person dies within a few hours. There are two forms: the primary. The secondary pneumonic plague.
Primary pneumonic plague is passed from person to person as a droplet infection. The pathogen penetrates directly into the lungs. The course is much more severe than that of bubonic plague. Untreated, the affected person dies of pulmonary edema. Circulatory failure within a few days.
Secondary pneumonic plague is a complication of bubonic plague, respectively plague sepsis.
The abortive plague is the most harmless variant of the plague. It manifests itself through a slight fever. Slight swelling of the lymph glands. Already after a few days the affected person develops antibodies. Is henceforth protected against this type of plague.
The incubation period (the time from infection to the outbreak of the disease) is a few hours or days to a week at the most.
– Influenza-like symptoms such as fever, headache and pain in the limbs, severe feeling of illness, drowsiness and even disturbances of consciousness – In addition, in bubonic plague: typical painful swellings (bumps) on the neck, in the armpit, in the groin; the bumps (ca. 4 cm in diameter) are caused by the infection of the lymph nodes and lymph vessels; due to the internal bleeding, the bumps turn blue-black in color. Later the ulcers fall off. – In addition, in plague sepsis : extensive bleeding of the skin and organs (blue-black coloration of the skin); Furthermore, gangrene formation (death of skin tie especially on the face and extremities, fingers, toes, then ascending). – Additionally, in case of pneumonic plague : shortness of breath, cough, cyanosis (blue coloration of the lips), black-bloody sputum, severe pain when coughing.
For the diagnosis of the plague different examinations and clarifications are accomplished. These include:
– Medical history including complaints and symptoms (swellings, sputum) – Detection of the pathogen in blood or saliva (simple rapid test) can be found from ca. the 10. Day of illness
With early treatment with antibiotics, a cure is practically certain. Untreated, many plague victims die.
In both bubonic and pneumonic plague, there is a risk of the pathogen spreading throughout the body via the bloodstream. Consequences: Plague sepsis or pneumonic plague (in bubonic plague).
Plague sepsis must be treated with antibiotics before 36 hours have elapsed, otherwise the affected person dies.
If pneumonic plague is not treated, the affected person develops pulmonary edema, circulatory failure occurs, the patent dies.
Preventive Measures (Preventive Measures)
There is a protective vaccination against bubonic plague, but this only provides protection for about 6 months and has proven to be insufficiently effective during epidemics. The vaccination has numerous side effects, so that the WHO (World Health Organization) only recommends it to risk groups (e.g., those at risk).B. Farmers, hunters, farm workers from regions where infected rodent populations are common) is recommended.
For prevention, fleas must be controlled by treating clothing and people with (powdered) insecticides. Strict adherence to hygiene rules is essential. In the long term, the spread of rats must be prevented. The care of plague victims requires special hygiene measures (gloves, mouth guards, separate clothing, etc.).)
Dr. med. Gerhard Emrich
Gerhard Emrich studied medicine in Vienna. He is a medical journalist with many years of experience in medical writing.
Doris Zumbuhl is a qualified medical practice assistant. She has several advanced training courses in journalism, IT and image processing.