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Plague, Yersinia Pestis Infection:

Dr. Monika Bhanushali
Dr. Monika Bhanushali
September23/ 2016

Plague has caused multiple pandemics throughout the history of the world. It has caused very high death rates in these pandemics spreading through Europe and Asia. It is also known as black death in the second and most destructive pandemic it has caused.

Plague is a disease which is caused because of the infection of bacteria Yersinia pestis.  The animal reservoirs of this bacteria are the rat flea. The fleas infect the rodents which again get bitten by other non- carrier fleas which ultimately transmit the disease to humans by flea bite.  However, serious outbreaks of the disease plague have been associated with the rise in the number of rodent population.


  1. The rat flea bites the human and then regurgitates the blood on the wound. This is the mode of transmission of the bacteria in the human body. the bacteria survive inside the human lymphatic system. It starts inflammation in the lymph nodes resulting in the formation of the bubo. It can also enter the blood stream and ultimately give rise to septicaemia.
  2. If the bacteria infect the lungs, then it results in pneumonic plague. Such person sprays bacteria at the time of sneezing and coughing in open air. This air droplets inhalation can also give rise to infection.
  3. Touching the body of an animal died from plague
  4. Inadvertent touching of the body fluid of a patient suffering from plague

Types of plague:

  1. Bubonic plague: there is a bubo formation
  2. Septicemic plague: the bacteria spread to the blood circulation
  3. Pneumonic plague: the bacteria enter the lung and cause respiratory symptoms.


There are multiple types of symptoms depending on the organ of affection:

  1. Bubo (swelling of the lymph nodes)
  2. gangrene
  3. Bleeding
  4. Coughing/ vomiting blood
  5. Head ache, weakness
  6. Respiratory distress
  7. Tonsillitis
  8. Meningitis
  9. Delirium
  10. coma

Bubo is the first manifestation of the progression of the illness. The symptoms appear suddenly after only a few days of exposure to the bacteria. These symptoms include chills, general feeling of weakness, high grade fever, fits, muscle cramps, lymph nodes swelling (more prominent in the groin and armpit region), pain precedes in the bubo formation. It can also result in gangrene in the toes, fingers, tip of the nose and lips.


  1. A patient’s blood or lymph node aspirate is necessary to establish the diagnosis of the infection. These body fluids are sent for Yersinia pestis culture to see the presence of the bacteria in the patient.
  2. Rapid dip stick method: with the help of this method, the bacterial antigen can be detected in the patients’ serum.


Following treatment modalities are used:

  1. Anti- bacterial medications: the anti- bacterial meds are quite effective in the early stage of the disease. The treatment should be given within 24 hrs of the appearance of the first symptoms in order to prevent death.
  2. Oxygen: it is used if the patients suffer from respiratory distress and breathing difficulties.
  3. Intravenous fluids: they are used to maintain fluid electrolytes balance.


Following methods are advised to prevent plague:

  • Prophylaxis: the people exposed to infected individuals are given anti biotics prophylactically in order to stop the infection from taking root.
  • Rodent control: keep the area surrounding your home clean. Recued the rodent infestation in your surroundings, make your home, office rodent- proof.
  • Keep your pets clean: don’t let your pets get flea infested. If they appear sick, take them to a veterinarian as soon as possible.
  • Flea control products: apply flea control products on the body of your animals.
  • Wear flea repellents: if you go hiking or working outdoors then remember to apply flea repellents.

Although plague was one of the notifiable disease to World health organisation till 2007, it’s incidence over the years has decreased and now It is prevalent in only some remote part of the world.

Dr. Monika Bhanushali
Dr. Monika Bhanushali

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