by Olaide Akande

Created on: August 19, 2009

Yersinia pestis is a bacteria belonging to the group of gram negative rods. It is the causative agent of the well known plague that has been responsible for large scale epidemics since the middle ages and up till the modern era. These epidemics affected places like Europe, Africa, China and Hong-Kong.

Plague is endemic in southwestern parts of US such as Arizona, New Mexico and Utah, however majority of cases seen nowadays are in the developing countries. In the US, only about 10 cases are reported yearly. The infection is zoonotic i.e. mainly affects animals, with domestic rats, wild rats, squirrels and prairie dogs been the main reservoirs.

The disease is passed to humans by the bite of an infected rat flea. Persons may also catch the infection by direct contact with infected rats or other animals. During epidemics, human to human transmission may occur with the pneumonic form of plague. In this instance transmission is by aerosolization of the bacteria. Yersinia pestis infection is an acute, highly contagious disease that can occur in various forms. All forms present with sudden onset fever with chills.

Bubonic Plague

The classic form is the Bubonic Plague in which the lymph glands become swollen, painful and red (buboes). The commonly affected glands are those of the groin, armpit and neck regions. Other symptoms include:

*Headache

*Body aches, weakness and exhaustion

*Abdominal pain and diarrhea

Pneumonic plague

Infection of the lungs by Yersinia pestis is seen more commonly in epidemics as a result of the ease of person to person transmission. It presents like pneumonia with:

*Cough

*Chest pain

*Difficult breathing

*Sputum which may be bloody

*Buboes may be absent

Septicaemic plague

This occurs when the bacteria invades the blood stream. This form is seen among elderly and debilitated patients. Symptoms are sudden and rapidly progressive and include

*Nausea

*Vomiting

*Abdominal pain

*Diarrhea

*Buboes are absent

Treatment

If you are a resident of the southwestern US and have recently been camping or hiking, and beaten by a flea, if you get any of the above symptoms, seek medical help immediately. Though a highly fatal disease if untreated, it is easily managed with use of antibiotics.

Antibiotic therapy is the main stay of treatment for all forms and should be started promptly as soon as infection with Yersinia pestis is suspected. The antibiotic of choice is an aminoglycoside such as gentamicin or streptomycin. For individuals

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