Causes and risk factors
Plague is cause by bacteria yersinia pestis which are found in fleas that feed on rodents. Plague can spread via flea bite, direct contact with the rodent or infected person through skin, or droplets in air released by infected person by coughing or sneezing. Major epidemics are caused when disease spreads mostly from rats to humans. Bite by fleas, rats, squirrels, rabbits, mice, can also cause the disease. Tropical environment, poor hygiene, poor sanitation, Overcrowded areas are the Contributing factors for spread of plague.
Clinical presentation
Plague is of 3 types. Bubonic, septicemic or pneumonic. ‘Bubonic’ plague is most common type. Bacteria are transmitted to humans by flea bite. Bacteria grows inside human body and shows symptoms like enlarged lymph node most commonly axillary and inguinal lymph nodes called a ‘bubo’, headache, swelling, pain, fever with chills, malaise. If it is untreated then it enters the blood & causes life threatening ‘septicemic’ plague. It presents with fever with chills, diarrhoea, vomiting, bleeding from gums, teeth, bowel, under the skin, gangrene and shock. ‘Pneumonic’ Plague is most dangerous type. It occurs when the bacteria enter lungs. It presents with cough, fever with chills, blood in sputum, chest pain and dyspnoea.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Samples to identify bacteria can be taken from blood, sputum or by lymph node aspirate.
Treatment
Isolation of the patient is required. Symptomatic care is necessary for a plague patient. Treatment with antibiotics analgesic and antipyretic drugs is given. For pneumonic plague patient, ventilator support, oxygen supply is needed.
Other Modes of treatment
The other modes of treatment can also be effective in treating plague. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating plague.
