Bubonic Plague

Definition

Definition of Bubonic Plague
Bubonic plague is a zoonotic disease, circulating mainly among small rodents and their fleas, and is one of three types of infections caused by Yersinia pestis (formerly known as Pasteurella pestis), which belongs to the family Enterobacteriaceae. Without treatment, the bubonic plague kills about two out of three infected humans within 4 days.

The term bubonic plague is derived from the Greek word ß??ß??, meaning "groin." Swollen lymph nodes (buboes) especially occur in the armpit and groin in persons suffering from bubonic plague. Bubonic plague was often used synonymously for plague, but it does in fact refer specifically to an infection that enters through the skin and travels through the lymphatics, as is often seen in flea-borne infections.

Symptoms

Symptoms of Bubonic Plague
The most infamous symptom of bubonic plague is an infection of the lymph glands (lymphadenitis), which become swollen and painful and are known as buboes. After being transmitted via the bite of an infected flea the Y. pestis bacteria become localized in an inflamed lymph node where they begin to replicate. Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral, groin and neck region. Acral gangrene (i.e. of the fingers, toes, lips and nose), is another common symptom. The black color of the necrotized tissue is the origin of the term "Black Death", the bubonic plague pandemic that swept Europe in the mid-fourteenth century.

Due to its bite-based form of infection, the bubonic plague is often the first step of a progressive series of illnesses. Bubonic plague symptoms appear suddenly, usually 2–5 days after exposure to the bacteria. Symptoms include:

1. Acral gangrene: Gangrene of the extremities such as toes, fingers, lips and tip of the nose
2. Chills
3. General ill feeling (malaise)
4. High fever (39 °Celsius; 102 °Fahrenheit)
5. Muscle Cramps
6. Seizures
7. Smooth, painful lymph gland swelling called a bubo, commonly found in the groin, but may occur in the armpits or neck, most often at the site of the initial infection (bite or scratch)
8. Pain may occur in the area before the swelling appears
9. Skin color changes to a pink hue in some extreme cases
10. Bleeding out of the cochlea will begin after 12 hours of infection

Causes

Causes of Bubonic Plague
Plague caused a fever, and black spots on your chest sometimes, and sometimes great big black swellings on your armpits and at the top of your legs. That's why they called it the Black Death. These swellings got hard like rocks and hurt, and then in a day or two people usually died. There was no effective treatment, though of course people tried all kinds of things, from magic to surgery. Sometimes people did get better on their own, if they had good nursing care and were very healthy to begin with.

Diagnosis

Diagnosis of Bubonic Plague
Consult with your doctor.

Treatment

Treatment of Bubonic Plague
Several classes of antibiotics are effective in treating bubonic plague. These include aminoglycosides such as streptomycin and gentamicin, tetracyclines (especially doxycycline), and the fluoroquinolone ciprofloxacin. Mortality associated with treated cases of bubonic plague is about 1-15%, compared to a mortality rate of 50-90% in untreated cases.

People potentially infected with the plague need immediate treatment and should be given antibiotics within 24 hours of the first symptoms to prevent death. Other treatments include oxygen, intravenous fluids, and respiratory support. People who have had contact with anyone infected by pneumonic plague are given prophylactic antibiotics.

Prognosis

Prognosis of Bubonic Plague
Consult with your doctor.

Prevention

Prevention of Bubonic Plague
The "Black Death" of the Middle Ages was due to large numbers of flea-ridden rats infesting homes and workplaces. In most developed countries, cities and towns have successfully controlled their rat populations, but rural and urban areas of developing countries often have problems with rat infestation, and thus are at risk of bubonic plague epidemics. Therefore, reducing the risk of plague outbreaks in these areas would require:

1. Controlling the rat population
2. Watching for plague cases in both rats and humans in the area
3. Using insecticide to reduce the number of fleas
4. Treating pets for fleas