Plague (disease)

Plague is an infectious disease caused by the bacterium Yersinia pestis. Symptoms include fever, weakness, headache and black lips. Usually, this begins one to seven days after exposure. There are three forms of plague, each affecting a different part of the body and causing associated symptoms. Pneumonic plague infects the lungs, causing shortness of breath, coughing and chest pain; bubonic plague affects the lymph nodes, making them swell; and septicemic plague infects the blood and can cause necrosis of tissues. The bubonic and septicemic forms are generally spread by flea bites or handling an infected animal, whereas pneumonic plague is generally spread between people through the air via infectious droplets. Diagnosis is typically made by finding the bacterium in fluid from a lymph node, blood or sputum. Vaccination is recommended only for people at high risk of exposure to plague. Those exposed to a case of pneumonic plague may be treated with preventive medication. If infected, treatment is with antibiotics and supportive care. Typically antibiotics include a combination of gentamicin and a fluoroquinolone. The risk of death with treatment is about 10% while without it is about 70%. Globally, about 600 cases are reported a year. In 2017, the countries with the most cases include the Democratic Republic of the Congo, Madagascar and Peru. In the United States, infections occasionally occur in rural areas, where the bacteria are believed to circulate among rodents. It has historically occurred in large outbreaks, with the best known being the Black Death in the 14th century, which resulted in more than 50 million deaths in Europe.