Symptoms of plague, as well as the epidemiology, modes of transmission and treatment

It is unlikely that you ever detect the symptoms of the plague. Once she endangered the entire city, it has claimed the lives of hundreds of millions of people around the world and caused the three most devastating pandemics in human history. But today it has become one of the most rare diseases. Although not disappeared altogether.

Plague

That the plague raged in the Middle ages, known to all. But not everyone knows that this disease is still relevant today. Despite all the measures taken to defeat him until the end and did not happen.

Since the middle of last century, after the discovery of antibiotics, plague has ceased to be mortally dangerous to humans, the number and size of outbreaks has been reduced, but not to bring it down to zero.

But still in the 2-3 year mark, thousands of cases, usually within the local outbreak, each of which is recorded from a few dozen to a few hundred patients. Typically, they are able to quickly enough to take control and prevent the spread of infection.

The most adverse from the point of view of epidemiology of the countries – Kazakhstan, Mongolia, China, Congo, Peru, Tanzania, USA and many others. Lesions present on all continents except Australia and Antarctica.

In Russia also there are several centers, mainly in the Astrakhan region, Dagestan, Kalmykia, in the Altai region, as well as in Chechen and Ingush Republics. The situation is complicated by proximity to Kazakhstan, China, Mongolia, between which the regular migration of the rodents-vectors.

In July 2016 in the Altai region in hospitalized boy was diagnosed with the bubonic form. While this is an isolated case, but in the Altai territory is the natural epidemiological focus – colony of marmots that carry pathogens. Hunting them is forbidden, and people who violates the prohibition is subject. For example, the boy helped his grandfather to cut the Groundhog.

The ways of spreading the plague

Although the plague is known for thousands of years, people has recently understood the mechanisms of distribution. Sources of plague in nature are rodents: marmots, gophers, voles, pikas, and urban rats and mice. Sometimes she infected predatory animals such as foxes. Home-it also affects camels and to a smaller degree cats. Dogs and farm animals are not sensitive to pathogens of the plague, but they can contribute to the spread of the disease.

The carriers of the plague – fleas of various kinds, rarely – other blood-sucking insects, such as mites and bedbugs. The process is accelerated because of the peculiarities of the course of disease in these insects. Bacteria clog the craw of blood-sucking insects, which consumed the blood enters the stomach and is brought up after the bite. Hungry flea begins to actively move in search of a new food source, increasing the number infected. Although the flea has a short life span, about 10 days, during this time, she manages to change on average about a dozen owners.

The infection is due to the fact that after the bite of a flea spits up just drinking the blood along with the bacteria. Because of the integrity of the skin at the site of the bite, the bacteria enter the human body.

There are several possible ways of human infection:

  • Through the bites of infected fleas.
  • Upon contact with the bodies of infected animals, especially the skinning and butchering of carcasses.
  • After being bitten by infected animals.
  • By eating meat of infected animals that has not been properly processed.
  • Upon contact with bodily fluids and tissues of infected people.
  • In contact with people who have pneumonic plague.

The largest and most devastating of the epidemic were associated with mixed modes of transmission: through bites of pathogens and diseased.

The speed of propagation and the number of victims depend on population density, hygienic conditions, the presence and quantity vectors, and the predominant form of the disease. Pneumonic plague is significantly accelerated the spread.

Plague pathogen – the plague Bacillus is not the most resistant bacteria. Boiling it breaks down almost immediately at a temperature of 55 degrees can withstand about half an hour. Combat is quite effective a disinfectant, it responds well to antibiotics and only to a lesser extent prone to emergence of resistance.

The classification of forms of the plague

Historically has distinguished two forms of plague – bubonic and pneumonic. Because the symptoms of these diseases vary greatly, peoplefor a long time did not bind them. Only at the beginning of the last century with the development of medicine and biology the doctors were able to prove that their agents are the same bacterium: plague Bacillus. While various types of plague are associated with the ways of penetration of pathogens in the human body.

Today there is a more comprehensive classification that takes into account all the variants of course:

  • Local. There are three types: bubonic, cutaneous and cutaneous-bubonic.
  • Externally disseminated. Causes of pulmonary flow. Can also be primary and secondary.
  • Generalized. Causes for septic. There are primary and secondary.
Most often, people are faced with the bubonic form of plague. Less common is primary pneumonic and primary septicaemic. At the same time, local forms can spontaneously go into secondary: pulmonary and septic.

The local form of the plague

Cutaneous plague – the easiest form with a favorable prognosis, but is quite rare. On the site of the bite there is a small, but painful pustules, filled with pus or blood. Later formed an ulcer with a black scab. After healing, the scar remains. Sometimes the bite is a furuncle or carbuncle. This form of the disease often takes place even without treatment, rarely causes complications and is transferred to the secondary pulmonary and septic.

With the bubonic form men historically face more often. On the site of the bite forms a papule or pustules. With increased swell large regional lymph nodes, most commonly the inguinal, sometimes the cervical, or axillary. They can reach 10 inches in diameter.

Plague buboes painful, firm to the touch, but after a few days they become soft, doughy. When taking puncture of a bubo there is a large amount of pus. After some time they are opened, forming extensive ulcers or fistulas.

Simultaneously, there are growing signs of intoxication: confusion, fever, weakness, chills, muscle and headaches. Often at the outset of a patient with bubonic plague develops a nervous excitement. Increases tachycardia, but the pressure falls.

Typically, bubonic plague sick after being bitten by an infected flea vector or infection from a sick animal. The incubation period is 4 to 6 days, in some cases from 1 to 12 days.

When the bubonic form of plague is dangerous intoxication, which can be violations of the heart and nervous system. It is often intoxication causes the death.

The disease can join pneumonia, meningitis, sepsis, pulmonary or septic form of plague.

Pneumonic plague

This is a relatively rare but extremely severe form of the disease. Most often it develops when pathogens are ingested via contaminated hands or objects and by inhalation of bacteria during communication with other people infected with this form.

Pneumonic plague is the only form of disease, in which infection is possible through airborne droplets. This greatly increases the number of potentially infected people.

The incubation period for primary pneumonic plague is short, can vary from a few hours to 7 days, on average, after 2-3 days the symptoms appear:

  • Tongue swollen, coated, covered with a dense white bloom.
  • Growing signs of intoxication: fever, muscle and headaches.
  • Possible nausea and vomiting.
  • High, up to 40-41 degrees.
  • Breathing shallow, there is shortness of breath, feeling of incomplete of breath and lack of air.
  • Growing respiratory and heart failure.

These symptoms of the disease is increasing rapidly within the first day. Without antibiotics, death can occur 1-2 days after infection.

The main and significant symptom is cough. At first, she pituitary, but gradually appear streaks of blood. Over time, it becomes foamy, al.

The sputum contains a large number of pathogens is very contagious.

Secondary pulmonary pneumonia develops in 5-15% of cases. The prognosis is more favorable than in the primary, but without treatment, the high probability of death.

A septic form

Like pneumonic plague, septic form may be primary and secondary. In the first case the infection occurs through the mucosa or the skin, especially damaged. The secondary is a frequent complication of bubonic plague in the terminal period

In this form, quickly develops sepsis and intravascular coagulation of blood. Other signs of the plague:

  • Diarrhea, vomiting, abdominal pain.
  • Bleeding from mouth, nose, rectum, subcutaneous hemorrhage.
  • Chills, fever.
  • Low pressure.
  • Gangrene of the extremities.
  • Septic shock.

This form of the disease refers to transient, no treatment, death occurs in 2-3 days. Time prescribed antibiotics significantly improve the prognosis. But because of the severity of the condition, still persists the probability of death at the level of 5-15%, depending on the speed of initiation of treatment, higher than for the most common bubonic plague.

Diagnosis of plague

Plague is a relatively rare disease, so there is still a danger of late diagnosis, especially of atypical forms.

So importantjust in time to recognize the symptoms. This is especially true for regions where there are existing epidemiological foci.

Therefore, diagnosis of this disease begins with a thorough medical history: did not attend any of the adverse from the point of view of epidemiology countries or regions, if he could contact the disease.

The second required part is the inspection and palpation of the lymph nodes. Their shape, size, texture, and appearance is one of the main signs of bubonic plague.

If the signs do not exclude the infected person, you may need a laboratory diagnosis to confirm. Use the following methods:

  • Bacteriological culture of the material is separable from ulcers, biopsy of the buboes, phlegm, and so on.
  • Search of antigens for Yersinia pestis in the blood.
  • Diagnosis using a characteristic of the plague bacteriophage.
  • Allergopharma used for retrospective diagnosis.
  • Biological sample. The prepared material is injected laboratory animals.

Importantly! Treatment of plague must begin as soon as possible, so often these diagnostic methods used to confirm the diagnosis already.

In addition, the laboratory methods used for the survey of persons who had contact with patients, and people with increased body temperature, identified in epidemiological lesion during outbreak. The incubation period can last up to 12 days, at this time often no obvious signs, so the observation and examination of potentially infected people is an important part of prevention of further spread.

Treatment of plague

Historically, the treatment of this disease was poorly effective. Not understanding the causes of illness, medieval doctors at best fought the buboes – cut or burned them. But in the course of the disease is not affected.

There are dozens of strange and ineffective methods such as the recommendation to lie down in turn on the right and left side.

The effectiveness of this treatment was very low – about 95% of patients with the bubonic form die. Pulmonary and septic form was considered virtually incurable, the percentage of recovery ranged at 1% level.

The turning point came in 1947. During the outbreak of bubonic plague in Manchuria doctors has pioneered a new antibiotic streptomycin. The result exceeded all their expectations – recovered all patients, including those who have started the pulmonary form. From that moment it became antibiotics to treat this disease.

With their help, the treatment efficiency amounted to 90-95%. The percentage of lethal cases is associated primarily with transient septic and pneumonic.

In addition, the treatment includes detoxification, prevention of dehydration, symptomatic therapy. More complex methods are required for the treatment of pulmonary and septic form. They include a complex of measures for the prevention of septic shock and disseminated intravascular coagulation.

Prevention of plague

Fortunately, today the disease does not cause large-scale epidemics, but still, prevention of plague is one of the main tasks of epidemiologists in areas where there is a valid source.

The main measures to prevent the spread are the following:

  • Upon detection of an infected person, it immediately isolated in an infectious diseases unit.
  • All people who had contact with him are also isolated, observe and diagnose.
  • It is important to determine the source of a disease – infected person – and try to get it under control.
  • All the doctors who will treat the disease at this period are of antiplague suits for any contact with patients, conducting research and procedures.
  • In some cases, isolated settlement to avoid the spread of the disease beyond its limits.
  • Conduct a thorough sanitation of the village from rats, mice, fleas.
  • Carry out explanatory work among the people, explaining the risk of contact with potentially infected animals, prohibit hunting, isolated a natural source.

These measures are quite effective and allow you to take such a dangerous disease under control. A lot depends on speed: the faster localized and isolated the source of the disease, the fewer people are at risk of infection.

Vaccination against plague

Against this disease there is a vaccine, but mass vaccination campaigns are carried out only when absolutely necessary to people belonging to the risk groups: hunters, doctors, biologists. The necessity of mass vaccination of people living in the region, no

It should be noted that existing vaccines are not the most effective. They can form an immune system for a year and protect in 70% of cases. But even if infecting the vaccinated person, the disease he will take much easier.

Plague is a dangerous disease today, so prevention and control are still relevant.

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