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The Bubonic Plague
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The bubonic plague is an acute, infectious disease present in rodents, humans, and ectoparasites (fleas, lice).
Historically, the bubonic plague has destroyed entire civilizations. In the 1300s, the "Black Death," as it was called, killed approximately one-third (20 to 30 million) of Europe's population. The plague killed 12 million people in the mid-1800s in China. Thanks to better living conditions, antibiotics, and improved sanitation, the disease is rare these days, occurring in a few thousand people worldwide each year.
The bubonic plague is caused by bacteria called Yersinia pestis. These plague bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them. Humans can also acquire the disease from rodent or flea bites.
(Click Plague and Animals or Causes of Bubonic Plague for more information.)
Besides the bubonic plague, there are two other kinds of plague:
These forms can occur in combination with bubonic plague.
(Click Types of Plague for more information.)
Bubonic plague transmission usually occurs in one of three ways:
When a person becomes infected with the bacteria that cause bubonic plague, the bacteria begin to multiply within the body. This occurs in the lymph system. Also known as the lymphatic system, this is a major component of your body's immune system. The organs within the lymphatic system are the tonsils, adenoids, spleen, and thymus. Symptoms of the bubonic plague can begin within one to six days of being infected. The period between becoming infected and the start of plague symptoms is called the bubonic plague incubation period.
It is possible for a person to first develop bubonic plague symptoms, followed several days later by septicemic plague symptoms, and then pneumonic plague symptoms.
(Click Symptoms of Plague or Pictures of Plague to learn more.)
If you think you have the bubonic plague, your doctor will ask a number of questions about your medical history and perform a physical exam before making a diagnosis. During the physical exam, your doctor will look at your skin and listen to the lungs for signs and symptoms of bubonic plague. If your doctor has a high suspicion that you have the disease, he or she will recommend certain tests.
Because several conditions share similar symptoms with the bubonic plague, your doctor will consider these and rule them out before making a definitive diagnosis. Some of these conditions include:
(Click How Is Bubonic Plague Diagnosed? for more information.)
Treatment for the Bubonic PlagueIf it is suspected that a person has the bubonic plague, treatment should be started even before lab tests come back, and the person should be hospitalized and placed in isolation. Treatment generally involves antibiotics. It is also important that people who have been in close contact with someone who has bubonic plague be identified and evaluated.
The bubonic plague can quickly progress, possibly causing septicemic plague, or even develop into pneumonic plague, if it is not treated early. The mortality rate is 50 to 90 percent if not treated; the rate is 15 percent when diagnosed and treated early.
Outbreaks of the bubonic plague will most likely continue to occur in wild rodent hosts, and will probably continue to exist in its many localized geographic areas around the world. Attempts to eliminate the plague in wild rodents are costly and futile; therefore, bubonic plague prevention is directed toward reducing the threat of infection in humans in high-risk areas through three techniques:
Approximately 10 to 20 people in the United States develop the bubonic plague in rural areas of the southwestern United States each year from flea or rodent bites (especially from infected prairie dogs). About one in seven of those infected die from it. There has not been a case of person-to-person infection in the United States since 1924.
Worldwide, there have been small plague outbreaks in Asia, Africa, and South America. Globally, the World Health Organization (WHO) reports 1,000 to 3,000 cases of the bubonic plague every year. Current statistics show there were 2,118 cases in 2003 worldwide.
The bubonic plague occurs more frequently during spring and summer months and in people under the age of 20 (especially men).
(Click Where Is Plague? for more information.)
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