plague

plague,

any contagious, malignant, epidemic disease, in particular the bubonic plague and the black plague (or Black Death), both forms of the same infection. These acute febrile diseases are caused by Yersinia pestis (Pasteurella pestis), discovered independently by Shibasaburo KitasatoKitasato, Shibasaburo
, 1852–1931, Japanese physician. He worked with Robert Koch in Germany (1885–91), and with Emil Behring he studied the tetanus bacillus and developed (1890) an antitoxin for diphtheria.
..... Click the link for more information. and Alexandre YersinYersin, Alexandre Émile Jean
, 1863–1943, French bacteriologist, of Swiss descent. He studied with Pasteur and worked on diphtheria antitoxin with P. P. E. Roux at the Pasteur Institute, Paris.
..... Click the link for more information. in 1894, a bacterium that typically is transmitted to people by fleas from rodents, in which epidemic waves of infection always precede great epidemics in human populations. People may also contract the disease through direct contact with infected animals and persons, and from fleas and lice from infected persons. When the disease occurs in rodents or other wild mammals in rural or wooded areas where they are prevalent, it is known as sylvatic plague; when it occurs in urban animal populations, typically rats, it is called urban plague.

Bubonic plague, the most common form, is characterized by very high fever, chills, prostration, delirium, hemorrhaging of the small capillaries under the skin, and enlarged, painful lymph nodes (buboes), which suppurate and may discharge. Invasion of the lungs by the organism (pneumonic plague) may occur as a complication of the bubonic form or as a primary infection. Pneumonic plague is rapidly fatal and is spread from person to person (by droplet spray) without intermediary transmission by fleas. In the black form of plague, hemorrhages turn black, giving the term "Black Death" to the disease. An overwhelming infection of the blood may cause death in three or four days, even before other symptoms appear.

In untreated cases of bubonic plague the mortality rate is approximately 50%–60%; pneumonic plague is usually fatal if not treated within 24 hours. Such antibiotics as streptomycin and tetracycline greatly reduce the mortality rate, especially of bubonic plague. Vaccine is available for preventive purposes. Rodent control is important in areas of known infection.

History

The oldest known evidence of the plague was identified in DNA collected from a woman buried in Sweden some 5,000 years ago. The earliest recorded visitation of the plague to Europe may have occurred in Athens in 430 B.C., but it is unclear if the disease that afflicated Athens was caused by Y. pestis. A disastrous epidemic occurred in the Mediterranean during the time of the Roman emperor Justinian; an estimated 25% to 50% of the population is reported to have succumbed. The most widespread epidemic began in Constantinople in 1334, spread throughout Europe (returning Crusaders were a factor), and in less than 20 years is estimated to have killed three quarters of the population of Europe and Asia. The great plague of London in 1665 is recorded in many works of literature. Quarantine measures helped contain the disease, but serious epidemics continued to occur even in the 19th cent. The disease is still prevalent in parts of Asia, and sporadically occurs elsewhere (approximately 2,500 cases worldwide annually). In Surat, India, in 1994, 5,000 cases of pneumonic plague were reported in an outbreak; an estimated 100 people died, and more than 400,000 people fled the city. Because the number of cases of plague has been increasing annually, it is categorized as a re-emerging infectious disease by the World Health Organization.

Bibliography

See P. Ziegler, The Black Death (1969); W. Whitman, Travel in Turkey, Asia Minor, Syria and Egypt (1971); R. S. Gottfried, The Black Death (1983); G. Twigg, The Black Death: A Biological Reappraisal (1985); R. Horrox, ed., The Black Death (1994); O. J. Benedictow, The Black Death 1346–1353: The Complete History (2004); W. Orent, Plague (2004); J. Aberth, The Black Death: The Great Mortality of 1348–1350 (2005); J. Kelly, The Great Mortality: An Intimate History of the Black Death (2005).

Plague

An infectious disease of humans and rodents caused by the bacterium Yersinia pestis. The sylvatic (wild-animal) form persists today in more than 200 species of rodents throughout the world. The explosive urban epidemics of the Middle Ages, known as the Black Death, resulted when the infection of dense populations of city rats living closely with humans introduced disease from the Near East. The disease then was spread both by rat fleas and by transmission between humans. During these outbreaks, as much as 50% of the European population died. At present, contact with wild rodents and their fleas, sometimes via domestic cats and dogs, leads to sporadic human disease. See Infectious disease

After infection by Y. pestis, fleas develop obstruction of the foregut, causing regurgitation of plague bacilli during the next blood meal. The rat flea, Xenopsylla cheopsis, is an especially efficient plague vector, both between rats and from rats to humans. Human (bubonic) plague is transmitted by the bite of an infected flea; after several days, a painful swelling (the bubo) of local lymph nodes occurs. Bacteria can then spread to other organ systems, especially the lung; fever, chills, prostration, and death may occur. Plague pneumonia develops in 10–20% of all bubonic infections. In some individuals, the skin may develop hemorrhages and necrosis (tissue death), probably the origin of the ancient name, the Black Death. The last primary pneumonic plague outbreak in the United States occurred in 1919, when 13 cases resulting in 12 deaths developed before the disease was recognized and halted by isolation of cases.

Bubonic plaque is suspected when the characteristic painful, swollen glands develop in the groin, armpit, or neck of an individual who has possibly been exposed to wild-animal fleas in an area where the disease is endemic. Immediate identification is possible by microscopic evaluation of bubo aspirate stained with fluorescent-tagged antibody. Antibiotics should be given if plague is suspected or confirmed. Such treatment is very effective if started early. The current overall death rate, approximately 15%, is reduced to less than 5% among patients treated at the onset of symptoms. See Immunofluorescence, Medical bacteriology

Plague

an acute infectious disease of man and animals, classified as a quarantine disease. The causative agent is the plague bacillus, Pasteurella pestis, discovered in 1894 by the French scientist A. Yersin (1863–1943) and the Japanese scientist Kitasato Shibasaburo (1852–1931). It is a coccoid gram-negative bacillus that grows well on ordinary culture media and is sensitive to physical and chemical factors, as well as to ordinary disinfectants. It dies within one minute of exposure to a temperature of 100°C.

Plague epidemics periodically swept many countries. The first pandemic, known in the literature as Justinian’s plague, occurred in the sixth century in the Eastern Roman Empire, affecting many countries and killing about 100 million persons in 50 years. The second pandemic, known as the Black Death, began in the 14th century. The third, which broke out at the end of the 19th century, was spread by ship rats to more than 100 ports in various countries. Occurrences of plague were recorded from the 14th century on in central and northwestern Russia, including numerous occurrences in Moscow. It occurred in Transbaikalia, Transcaucasia, and the Caspian Region in the 19th century and in Odessa and other Black Sea ports at the end of the 19th and early 20th centuries, where it was brought in by plague-infected rats. Major epidemics were recorded in India in the 20th century.

Plague is characterized by natural endemism, associated with desert, steppe, and mountain landscapes, where the epizootic process is maintained by certain rodent species; however, other rodents, as well as hares, camels, and other mammals, are also dangerous to man. The epidemiological danger increases when plague is introduced into populations of commensal rodents, such as rats. The disease is transmitted to humans by animals through fleas; less common is infection as a result of direct contact, usually contracted when dressing the carcasses of infected animals. Humans infect other humans through fleas. When the bubonic form is complicated by pneumonia (secondary pneumonic plague), the disease is spread by airborne droplets, like influenza, and the highly contagious primary pneumonic plague occurs. Depending on the mechanism of infection, the causative agent penetrates the organism through the skin, the mucosa of the upper respiratory tract, and the conjunctiva. Carriers of the plague bacillus (in the nasopharynx) have been discovered.

The incubation period of plague is two to six days. The disease is characterized by sudden onset, chills, severe headache, agitation, and mental confusion. The body temperature rises to 40°C, and hyperemia of the face is observed. Frequently, the meninges become involved. In the bubonic form painful buboes appear on different parts of the body; symptoms of pneumonia appear in the pneumonic form. The course is generally severe. Bacteriological and serological methods are used for laboratory diagnosis.

Treatment includes the administration of streptomycin and other antibiotics. Preventive measures include epidemiological reconnaissance in areas where the disease is endemic (epizootological survey and observation of human and animal populations) and the use of live vaccines. To achieve early and emergency prophylaxis, the extermination of rodents and fleas in the wild and in dwellings is vital. In the event of an epidemic, infected persons are hospitalized, and individuals who have come in contact with them are isolated and given prophylactic treatment. Disinfection and quarantine measures are also instituted.

REFERENCES

Nikolaev, N. I. Chuma. Moscow, 1968.
Obshchaia i chastnaia epidemiologiia, vol. 2. Moscow, 1973. Pages 337–356.

G. D. OSTROVSKII

plague

[plāg] (medicine) An infectious bacterial disease of rodents and humans caused by Pasteurella pestis, transmitted to humans by the bite of an infected flea (Xenopsylla cheopis) or by inhalation. Also known as black death; bubonic plague. Any contagious, malignant, epidemic disease.

plague

1. any widespread and usually highly contagious disease with a high fatality rate 2. an infectious disease of rodents, esp rats, transmitted to man by the bite of the rat flea (Xenopsylla cheopis) 3. See bubonic plague4. a pestilence, affliction, or calamity on a large scale, esp when regarded as sent by God

plague

Plague

Definition

Plague is a serious, potentially life-threatening infectious disease that is usually transmitted to humans by the bites of rodent fleas. It was one of the scourges of early human history. There are three major forms of the disease: bubonic, septicemic, and pneumonic.

Description

Plague has been responsible for three great world pandemics, which caused millions of deaths and significantly altered the course of history. A pandemic is a disease occurring in epidemic form throughout the entire population of a country, a people, or the world. Although the cause of the plague was not identified until the third pandemic in 1894, scientists are virtually certain that the first two pandemics were plague because a number of the survivors wrote about their experiences and described the symptoms.The first great pandemic appeared in AD 542 and lasted for 60 years. It killed millions of citizens, particularly people living along the Mediterranean Sea. This sea was the busiest, coastal trade route at that time and connected what is now southern Europe, northern Africa, and parts of coastal Asia. This pandemic is sometimes referred to as the Plague of Justinian, named for the great emperor of Byzantium who was ruling at the beginning of the outbreak. According to the historian Procopius, this outbreak of plague killed 10,000 people per day at its height just within the city of Constantinople.The second pandemic occurred during the fourteenth century, and was called the Black Death because its main symptom was the appearance of black patches (caused by bleeding) on the skin. It was also a subject found in many European paintings, drawings, plays, and writings of that time. The connections between large active trading ports, rats coming off the ships, and the severe outbreaks of the plague were understood by people at the time. This was the most severe of the three, beginning in the mid-1300s with an origin in central Asia and lasting for 400 years. Between a fourth and a third of the entire European population died within a few years after plague was first introduced. Some smaller villages and towns were completely wiped out.The final pandemic began in northern China, reaching Canton and Hong Kong by 1894. From there, it spread to all continents, killing millions.The great pandemics of the past occurred when wild rodents spread the disease to rats in cities, and then to humans when the rats died. Another route for infection came from rats coming off ships that had traveled from heavily infected areas. Generally, these were busy coastal or inland trade routes. Plague was introduced into the United States during this pandemic and it spread from the West towards the Midwest and became endemic in the Southwest of the United States.About 10-15 Americans living in the southwestern United States contract plague each year during the spring and summer. The last rat-borne epidemic in the United States occurred in Los Angeles in 1924–25. Since then, all plague cases in this country have been sporadic, acquired from wild rodents or their fleas. Plague can also be acquired from ground squirrels and prairie dogs in parts of Arizona, New Mexico, California, Colorado, and Nevada. Around the world, there are between 1,000 and 2,000 cases of plague each year. Recent outbreaks in humans occurred in Africa, South America, and Southeast Asia.Some people and/or animals with bubonic plague go on to develop pneumonia (pneumonic plague). This can spread to others via infected droplets during coughing or sneezing.Plague is one of three diseases still subject to international health regulations. These rules require that all confirmed cases be reported to the World Health Organization (WHO) within 24 hours of diagnosis. According to the regulations, passengers on an international voyage who have been to an area where there is an epidemic of pneumonic plague must be placed in isolation for six days before being allowed to leave.While plague is found in several countries, there is little risk to United States travelers within endemic areas (limited locales where a disease is known to be present) if they restrict their travel to urban areas with modern hotel accommodations.Over the past few years, this infection primarily of antiquity has become a modern issue. This change has occurred because of the concerns about the use of plague as a weapon of biological warfare or terrorism (bioterrorism). Along with anthrax and smallpox, plague is considered to be a significant risk. In this scenario, the primary manifestation is likely to be pneumonic plague transmitted by clandestine aerosols. It has been reported that during World War II the Japanese dropped "bombs" containing plague-infected fleas in China as a form of biowarfare.

Causes and symptoms

Fleas carry the bacterium Yersinia pestis, formerly known as Pasteurella pestis. The plague bacillus can be stained with Giemsa stain and typically looks like a safety pin under the microscope. When a flea bites an infected rodent, it swallows the plague bacteria. The bacteria are passed on when the fleas, in turn, bite a human. Interestingly, the plague bacterium grows in the gullet of the flea, obstructing it and not allowing the flea to eat. Transmission occurs during abortive feeding with regurgitation of bacteria into the feeding site. Humans also may become infected if they have a break or cut in the skin and come in direct contact with body fluids or tissues of infected animals.More than 100 species of fleas have been reported to be naturally infected with plague; in the western United States, the most common source of plague is the golden-manteled ground squirrel flea. Chipmunks and prairie dogs have also been identified as hosts of infected fleas.Since 1924, there have been no documented cases in the United States of human-to-human spread of plague from droplets. All but one of the few pneumonic cases have been associated with handling infected cats. While dogs and cats can become infected, dogs rarely show signs of illness and are not believed to spread disease to humans. However, plague has been spread from infected coyotes (wild dogs) to humans. In parts of central Asia, gerbils have been identified as the source of cases of bubonic plague in humans.

Bubonic plague

Two to five days after infection, patients experience a sudden fever, chills, seizures, and severe

Plague is a serious infectious disease transmitted by the bites of rat fleas. There are three major forms of plague: bubonic, pneumonic, and septicemic. As illustrated above, fleas carry the bacterium Yersinia pestis. When a flea bites an infected rodent, it becomes a vector and then passes the plague bacteria when it bites a human. (Illustration by Electronic Illustrators Group.)headaches, followed by the appearance of swellings or "buboes" in armpits, groin, and neck. The most commonly affected sites are the lymph glands near the site of the first infection. As the bacteria multiply in the glands, the lymph node becomes swollen. As the nodes collect fluid, they become extremely tender. Occasionally, the bacteria will cause an ulcer at the point of the first infection.

Septicemic plague

Bacteria that invade the bloodstream directly (without involving the lymph nodes) cause septicemic plague. (Bubonic plague also can progress to septicemic plague if not treated appropriately.) Septicemic plague that does not involve the lymph glands is particularly dangerous because it can be hard to diagnose the disease. The bacteria usually spread to other sites, including the liver, kidneys, spleen, lungs, and sometimes the eyes, or the lining of the brain. Symptoms include fever, chills, prostration, abdominal pain, shock, and bleeding into the skin and organs.

Pneumonic plague

Pneumonic plague may occur as a direct infection (primary) or as a result of untreated bubonic or septicemic plague (secondary). Primary pneumonic plague is caused by inhaling infective drops from another person or animal with pneumonic plague. Symptoms, which appear within one to three days after infection, include a severe, overwhelming pneumonia, with shortness of breath, high fever, and blood in the phlegm. If untreated, half the patients will die; if blood poisoning occurs as an early complication, patients may die even before the buboes appear.Life-threatening complications of plague include shock, high fever, problems with blood clotting, and convulsions.

Diagnosis

Plague should be suspected if there are painful buboes, fever, exhaustion, and a history of possible exposure to rodents, rabbits, or fleas in the West or Southwest. The patient should be isolated. Chest x rays are taken, as well as blood cultures, antigen testing, and examination of lymph node specimens. Blood cultures should be taken 30 minutes apart, before treatment.A group of German researchers reported in 2004 on a standardized enzyme-linked immunosorbent assay (ELISA) kit for the rapid diagnosis of plague. The test kit was developed by the German military and has a high degree of accuracy as well as speed in identifying the plague bacillus. The kit could be useful in the event of a bioterrorist attack as well as in countries without advanced microbiology laboratories.

Treatment

As soon as plague is suspected, the patient should be isolated, and local and state departments notified. Drug treatment reduces the risk of death to less than 5%. The preferred treatment is streptomycin administered as soon as possible. Alternatives include gentamicin, chloramphenicol, tetracycline, or trimethoprim/sulfamethoxazole.

Prognosis

Plague can be treated successfully if it is caught early; the mortality rate for treated disease is 1-15% but 40-60% in untreated cases. Untreated pneumonic plague is almost always fatal, however, and the chances of survival are very low unless specific antibiotic treatment is started within 15-18 hours after symptoms appear. The presence of plague bacteria in a blood smear is a grave sign and indicates septicemic plague. Septicemic plague has a mortality rate of 40% in treated cases and 100% in untreated cases.

Prevention

Anyone who has come in contact with a plague pneumonia victim should be given antibiotics, since untreated pneumonic plague patients can pass on their illness to close contacts throughout the course of the illness. All plague patients should be isolated for 48 hours after antibiotic treatment begins. Pneumonic plague patients should be completely isolated until sputum cultures show no sign of infection.Residents of areas where plague is found should keep rodents out of their homes. Anyone working in a rodent-infested area should wear insect repellent on skin and clothing. Pets can be treated with insecticidal dust and kept indoors. Handling sick or dead animals (especially rodents and cats) should be avoided.Plague vaccines have been used with varying effectiveness since the late nineteenth century. Experts believe that vaccination lowers the chance of infection and the severity of the disease. However, the effectiveness of the vaccine against pneumonic plague is not clearly known.Vaccinations against plague are not required to enter any country. Because immunization requires multiple doses over a 6-10 month period, plague vaccine is not recommended for quick protection during outbreaks. Moreover, its unpleasant side effects make it a poor choice unless there is a substantial long-term risk of infection. The safety of the vaccine for those under age 18 has not been established. Pregnant women should not be vaccinated unless the need for protection is greater than the risk to the unborn child. Even those who receive the vaccine may not be completely protected. The inadequacy of the vaccines available as of the early 2000s explains why it is important to protect against rodents, fleas, and people with plague. A team of researchers in the United Kingdom reported in the summer of 2004 that an injected subunit vaccine is likely to offer the best protection against both bubonic and pneumonic forms of plague.

Key terms

Bioterrorism — The use of disease agents to terrorize or intimidate a civilian population.Buboes — Smooth, oval, reddened, and very painful swellings in the armpits, groin, or neck that occur as a result of infection with the plague.Endemic — A disease that occurs naturally in a geographic area or population group.Epidemic — A disease that occurs throughout part of the population of a country.Pandemic — A disease that occurs throughout a regional group, the population of a country, or the world.Septicemia — The medical term for blood poisoning, in which bacteria have invaded the bloodstream and circulates throughout the body.

Resources

Books

Beers, Mark H., MD, and Robert Berkow, MD., editors. "Plague (Bubonic Plague; Pestis; Black Death)." In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Periodicals

Davis, S., M. Begon, L. DeBruyn, et al. "Predictive Thresholds for Plague in Kazakhstan." Science 304 (April 30, 2004): 736-738.Gani, R., and S. Leach. "Epidemiologic Determinants for Modeling Pneumonic Plague Outbreaks." Emerging Infectious Diseases 10 (April 2004): 608-614.Splettstoesser, W. D., L. Rahalison, R. Grunow, et al. "Evaluation of a Standardized F1 Capsular Antigen Capture ELISA Test Kit for the Rapid Diagnosis of Plague." FEMS Immunology and Medical Microbiology 41 (June 1, 2004): 149-155.Titball, R. W., and E. D. Williamson. "Yersinia pestis (Plague) Vaccines." Expert Opinion on Biological Therapy 4 (June 2004): 965-973.Velendzas, Demetres, MD, and Susan Dufel, MD. "Plague." eMedicine December 2, 2004. http://www.emedicine.com/EMERG/topic428.htm.

Organizations

Centers for Disease Control. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. http://www.cdc.gov.National Institute of Allergies and Infectious Diseases, Division of Microbiology and Infectious Diseases. Bldg. 31, Rm. 7A-50, 31 Center Drive MSC 2520, Bethesda, MD 20892.World Health Organization. Division of Emerging and Other Communicable Diseases Surveillance and Control. 1211 Geneva 27, Switzerland.

Other

Bacterial Diseases (Healthtouch). 〈http://www.healthtouch.com/level1/leaflets/105825/105826.htm〉.Bug Bytes. 〈http://www.isumc.edu/bugbytes/〉.Centers for Disease Control. http://www.cdc.gov/travel/travel.html.Infectious Diseases Weblink. 〈http://pages.prodigy.net/pdeziel/〉.International Society of Travel Medicine. http://www.istm.org.World Health Organization. http://www.who.ch/.

plague

[plāg] an acute febrile, infectious, highly fatal disease caused by the bacillus Yersinia pestis. It is primarily a disease of rats and other rodents and is usually spread to human beings by fleas. The most common form is bubonic plague.Pneumonic plague is a second type, which can be spread directly between humans by droplet infection.
Plague is a devastating disease; three outbreaks in history wiped out whole populations. The first of these spread over Europe in the sixth century a.d. in a tremendous cycle of pestilence that lasted for more than 50 years. The second, called the “Black Death,” was perhaps the most deadly outbreak the world has ever known. It swept over Europe in the 14th century, and in many areas up to three quarters of the population perished; perhaps 25 million Europeans died. The “Great Plague of London” in 1665 was actually a relatively minor outbreak. A third great epidemic raged in Asia at the turn of the 20th century. The greatest toll was in India, where there were more than 12 million deaths from 1896 to 1933.
Some cases have occurred in the United States. Extensive epidemics have been prevented in this country by strict quarantines and by sanitation measures that have been enforced since the disease was traced to rat and wild rodent fleas.Bubonic Plague. Bubonic plague is characterized by acutely inflamed and painful swellings of the lymph nodes, or buboes, usually in the groin. The disease strikes suddenly with chills and fever. Children may have convulsions. There is vomiting and thirst, generalized pain, headache, and mental dullness. Delirium may also be present. After the third day, black spots, which give the disease the name “black death,” may appear on the skin. Tender, enlarged lymph nodes are usually seen between the second and fifth days. Some cases of bubonic plague are mild. The more virulent cases last 5 or 6 days and are usually fatal. If the patient survives past the tenth or twelfth day, there is a good chance of recovery. The mortality rate for untreated cases is usually between 25 and 50 per cent, but has reached as high as 90 per cent. When antibiotic therapy is administered promptly (see Treatment), the mortality rate can be as low as 5 per cent.Pneumonic Plague. Pneumonic plague usually occurs during outbreaks of bubonic plague and may be a direct complication of it. There is extensive involvement of the lungs, and the sputum contains many organisms. At one time, pneumonic plague was always fatal. Now, when antibiotic therapy is administered promptly (see Treatment), the mortality rate is much lower.Prevention. The most important measure in controlling plague is the extermination of rats. This is especially necessary around shipping areas, in warehouses, and on docks. Rat control for ships arriving from plague areas is vital. Where there is an outbreak of plague, strict quarantine measures are called for, as well as the use of insecticides to protect inhabitants of the stricken area against fleas. Immunization with plague vaccine is recommended only for persons whose occupation requires contact with possibly infected rodents.
A consensus statement called “Plague as a Biological Weapon” has been issued by the Working Group on Civilian Biodefense. It notes the danger that would be associated with an aerosol plague weapon.Treatment. Prompt treatment is essential with antibiotics, which can also be used for prophylaxis. Antibiotics of choice are streptomycin, gentamicin, tetracycline, and fluoroquinolones.

plague

(plāg), 1. Any disease of wide prevalence or of excessive mortality. 2. An acute infectious disease caused by the bacterium Yersinia pestis and marked clinically by high fever, toxemia, prostration, a petechial eruption, lymph node enlargement, pneumonia, or hemorrhage from the mucous membranes; primarily a disease of rodents, transmitted to humans by fleas that have bitten infected animals. In humans the disease takes one of four clinical forms: bubonic plague, septicemic plague, pneumonic plague, or ambulant plague Synonym(s): pest, pestilence (1) , pestis [G. plege, a stroke, a wound; L. plaga, a stroke, injury]

plague

(plāg)n.a. A highly infectious, usually fatal, epidemic disease; a pestilence.b. A virulent, infectious disease that is caused by the bacterium Yersinia pestis (syn. Pasteurella pestis) and is transmitted primarily by the bite of fleas from an infected rodent, especially a rat. In humans it occurs in bubonic form, marked by lymph node enlargement, and in pneumonic form, marked by infection of the lungs, and can progress to septicemia.

plagu′er n.

plague

Infectious disease An epidemic infection by Yersinia pestis spread to humans by fleas bitten by infected rodents–bubonic or septicemic plague or by inhalation of highly virulent encapsulated Y pestis when in close quarters with infected Pts–1º pneumonic plague Clinical forms Bubonic–90%, septicemic, pneumonic and, as a complication of any of these, meningitis Clinical Fever, chills, prostration, headache, N&V, diarrhea Treatment Streptomycin, tetracycline, chloramphenicol. See Bubonic plague, Fifth plague of Egypt.

plague

(plāg) 1. Any disease of wide prevalence or of excessive mortality. 2. An acute infectious disease caused by Yersinia pestis marked by high fever, toxemia, prostration, a petechial eruption, lymph node enlargement, and pneumonia, or hemorrhage from the mucous membranes; primarily a disease of rodents, transmitted to humans by fleas that have bitten infected animals. In humans, the disease takes one of four clinical forms: bubonic plague, septicemic plague, pneumonic plague, or ambulant plague.
Synonym(s): pestilence (1) .
See also: black death[G. plege, a stroke, a wound; L. plaga, a stroke, injury]

plague

A serious infectious disease endemic in rats and spread to humans by rat fleas. Plague is caused by the organism Yersinia pestis and takes two main forms, bubonic and pneumonic. The latter is a complication of bubonic plague and can be spread by coughed droplets.

Bubonic plague features high fever, shivering, severe headache, painful swelling of the LYMPH NODES (buboes), especially in the groins, armpits and neck, seizures and, in untreated cases, death. SEPTICAEMIA and pneumonic plague are especially dangerous complications. Treatment is with antibiotics such as STREPTOMYCIN, TETRACYCLINE or CHLORAMPHENICOL. These reduce the mortality to less than 5%. Also known as the ‘black death’.

plague

(plāg) Widely prevalent disease or one causing excessive mortality. [G. plege, a stroke, a wound; L. plaga, a stroke, injury]

plague

plague

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a plague on both your houses

avoid (someone or something) like the plague

enough to plague a saint

plague (one) with (something)

avoid someone or something like the plague

enough something to plague a saint

plague someone or something with something

avoid like the plague

avoid someone/something like the plague

avoid somebody/something like the ˈplague

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avoid like the plague, to

plague

plague,

History

Bibliography

Plague

Plague

REFERENCES

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Plague

Definition

Description

Causes and symptoms

Bubonic plague

Septicemic plague

Pneumonic plague

Diagnosis

Treatment

Prognosis

Prevention

Key terms

Resources

Books

Periodicals

Organizations

Other

plague

plague

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Synonyms for plague

noun disease

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noun infestation

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noun bane

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noun nuisance

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verb torment

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verb pester

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Synonyms for plague

noun a cause of suffering or harm

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noun a sudden increase in something, as the occurrence of a disease

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noun something that annoys

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verb to disturb by repeated attacks

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