Plague

Plague is a serious infectious disease whose pathogen is Yersinia pestis. With the exception of the pneumonic and pharyngeal forms, it is spread by the bite of a flea carried by rats. The disease presents in several different. all potentially fatal, ways, all caused by the same organism:

1. bubonic, with distinctive blue-black skin swellings og lymph glands such as in the axilla (i.e., armpit) or groin. The victim also has a high fever, head and body aches, chills, and exhaustion.
2. meningeal. with the symptoms of bubonic plague plus a stiff neck and neurological symptoms
3. pharyngeal, perhaps the mildest form, with sore throat, fever, and swollen lymph nodes in the neck
4. pneumonic, the only form transmitted directly between humans. It has abrupt onset with chest pain, cough, difficulty in breathing, high fever, and sputum tinged with blood or pus. It can kill with hours of the onset of symptoms.
5. septicemic, rare but also highly lethal, carried in the bloodstream. There are no buboes, although diarrhea will accompany high fever.

Streptomycin, doxycycline, and chloramphenicol are the usual antibiotics, with streptomycin the drug of choice. Local experience and sensitivity, and preferably laboratory assessments of sensitivity, should guide therapy.