Pneumonic plague: is the most important information in one article

Pneumonic plague

Pneumonic plague is a rare but most dangerous for human form of the disease. The main danger to humans is the ability to spread by airborne droplets, that significantly accelerates the spread among the people.

It is an acute infectious disease causing gram – negative bacterium, plague Bacillus. It causes not only lung, but also the more common bubonic plague.

It is also called plague pneumonia and pneumonic plague, because the disease develops primarily in the lungs.

Plague – the disease is insidious and complex. It can have several forms of current, depending on how the bacteria got into the human body.

Historically, that basically the disease is transmitted through flea bites and contact with infected animals. Accordingly, the pathogen has entered the body of a healthy person through microscopic damage to the skin. This way of infection is the conventional over the formation of a major plague buboes in the lymph nodes.

Form of pneumonic plague

There are two forms of course of disease:

• Primary. The disease initially develops in a scenario of pneumonic plague. For such a flow is characterized by a rapid and acute onset with a short incubation period of 1-3 days instead of 5-7 for the classical flow. Without treatment death is possible 2-3 days after infection.
• Secondary. Developing the classical trend in 5-10% of cases, when the infection proceeds to lung tissue. Unlike the primary form, for benign, without the rapid development and increasing symptoms.

It should be noted that the primary and secondary forms have similar symptoms, and are also the tap threat from the point of view of epidemiology. These forms differ from other high contagiousness, since they allow the infected airborne droplets.

Way of infection

If the secondary form develops on the background of standard flow, for the beginning of the primary it is necessary that the pathogen is deposited directly into the lungs. There are several ways:

• Droplet in contact with patients with plague pneumonia. They are extremely dangerous to everyone around them, especially when the disease is in the active form. The patient has bacteria in the environment by breathing the droplets of saliva during coughing. They are also in large quantity are contained in the sputum.
• Direct introduction of bacteria into the lungs. Typically, this occurs through contaminated hands or objects, for example, a pipe or Cutlery. This is a relatively rare way, but it is theoretically possible it is.
• Other way. Inhalation of fumes, penetration of bacteria through the conjunctiva of the eye is clinically possible, but the probability of this happening is quite low.

In secondary pneumonia, the bacterium enters the lungs through the blood or lymph.

Clinical picture

In primary forms there are three stages:

• Incubation period. In this course it is short, from the initial contact may take from several hours to several days. At this time in the lungs grow colonies of bacteria, causing inflammation.
• First-stage. There are plague symptoms and the cough and other symptoms of pneumonia. Structural changes in the lungs not.
• Second stage. In the structure of light there are significant changes, there are growing signs of respiratory failure. It was at this time a sick man secretes the maximum quantity of bacteria.

Symptoms and signs

The symptoms of this disease are varied but not specific. The infected person displays the following signs:

• In the first day there signs of intoxication: the temperature rises to 40-41 degrees, starts shivering, you experience muscle pain, lower back pain, excruciating headaches, weakness, nausea and vomiting.
• A growing feeling of compression in chest, breathing is difficult, patient can't breathe, starts panting, breathing rapid, but superficial. At the same time, when listening to the lungs are not detected wheezing.
• There is a faint cough with sputum. At first it slimy, perhaps with an admixture of pus, and sometimes vitreous.Then there are streaks of blood. In advanced stage the sputum becomes copious, frothy, bloody.

In this course of the disease in 2-3 days develops respiratory failure and shock leading to death.

Diagnosis of plague in this form difficult the rapid flow and lack of characteristic symptoms. General intoxication and coughing up blood accompany many diseases, therefore timely diagnosis is of great importance taking a history and understanding of the epidemiological situation.

One of the important diagnostic signs is the rapid increase of the symptoms, as well as the discrepancy between the gravity of a relatively small number of incidents as well as the absence of changes in the lungs.

Diagnosis of pneumonic plague

Diagnosis of plague in the primary pulmonary form is often hampered by the lack of characteristic clinical manifestations. In the early stages of the disease there is no typical buboes, and present symptoms may accompany other infectious diseases.

There are two methods that give quick, but not accurate result:

• Luminescent-serological analysis. Has a high sensitivity to pathogens of this disease and the relatively high risk of false responses, is therefore used for primary diagnosis.
• Reaction with plague with bacteriophage. This particular bacteriophage only reacts when the solution is present, the causative agent of plague. Commit changes in the serum confirms the diagnosis.

With their help, you can get the result after a few hours, but to confirm the diagnosis using more accurate but slower tests: bacterial examination, biological test on mice or Guinea pigs. In the first case the pathogen in a nutrient solution forms a characteristic colony in the second – in laboratory animals showing signs of disease.

Also relatively often use another method of diagnosis – allergodil. Under the skin is injected with a small dose of the drug which gives a positive reaction after the disease, and in the presence of formed after vaccination immunity. Therefore, the analysis is carried out to determine whether re-vaccination or the last vaccination is still valid.

Treating illness

Given the rapid course of the disease, for treatment the doctors are waiting for confirmation of the diagnosis. Quite often, external signs and likelihood of infection, in order to start specific therapy.

Given the high contagionist the pneumonic form, patients are immediately transferred to the infectious diseases Department and isolated in a special isolation chamber stopping any unprotected contact with medical staff or relatives.

With timely treatment of the disease, the prognosis is favorable. For a long time the drug of first choice is streptomycin. In some cases the agent may be insensitive to this antibiotic, and then can prescribe drugs from other groups, for example, tetracycline.

In addition, great importance is symptomatic therapy. Depending on the human being, prescribed anti-inflammatories, painkillers, pick an effective detoxification and therapy aimed at maintaining normal breathing and heart, are they not the most commonly associated complications.

Overall, early treatment of this disease leaves high chances for a full recovery and restoration. But still, the probability of death on average is kept at 10-15%, significantly higher than that for the bubonic form. This is due to the rapid course and lack of characteristic features, which treatment does not always start on time.

This demonstrated one of the latest outbreaks of pneumonic plague in India. The emergence in Surat this disease has led to a local epidemic, which killed 56 people. In the hospital there were several people with signs of severe respiratory infections, five of whom died within the first day. And only three days later, the doctors suspected the plague. The attempt to establish the cordons led to panic, people began to flee the city, carrying the disease across India.

Prevention of plague

To prevent the spread of the disease among people who developed a clear and comprehensive scheme that takes into account all stages:

• Monitoring of natural foci, control of animal. The introduction of the ban on their visit, as well as hunting animals.
• Informing the public about the potential threat of plague, how widespread and howinfections.
• Preventive immunization of people at risk.
• Informing medical personnel about the signs of the plague, risk groups, symptoms and required actions upon detection.
• When it detects a potentially infected person, immediate isolation, diagnosis and initiation of treatment.
• Detection, isolation and diagnosis of all people with whom he communicated in the last 10-15 days. All prophylactically prescribe a course of streptomycin, up to 5 days.
• Strict adherence to safety rules and laboratory staff who work with the patient.

Patients with bubonic plague is not dangerous for others, but the pulmonary form they can infect a large number of people, so isolation and control of distribution – the problem of first priority.