Plague : Diagnosis, Treatment and Prevention

by National Institute of Health

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What are the symptoms? Within 1 to 3 days of exposure to airborne droplets of pneumonic plague, fever, headache, weakness, rapid onset of pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery sputum develop.

Is it contagious? Pneumonic plague is contagious. If someone has pneumonic plague and coughs, Y. pestis bacteria suspended in respiratory droplets is released into the air. An uninfected person can then develop pneumonic plague by breathing in those droplets.

Diagnosis

A health care provider can diagnosis plague by doing laboratory tests on blood or sputum or on fluid from a lymph node.

Treatment

When the disease is suspected and diagnosed early, a health care provider can prescribe specific antibiotics, generally streptomycin or gentamycin as treatment options. Certain other antibiotics are also effective. Left untreated, bubonic plague bacteria can quickly multiply in the bloodstream, causing septicemic plague, or even progress to the lungs, causing pneumonic plague.

Prevention

Antibiotics

Health experts recommend antibiotics if you have been exposed to wild rodent fleas during a plague outbreak in animals, or to a possible plague-infected animal. Because there are so few cases of plague in the United States, experts do not recommend taking antibiotics unless its certain there has been exposure to plague-infected fleas or animals.

Vaccine

Currently, there is no commercially available vaccine against plague.

How Common Is Plague?

Approximately 10 to 20 people in the United States develop plague each year from flea or rodent bites-primarily from infected prairie dogs-in rural areas of the southwestern United States. About one in seven of those infected die from the disease. 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.

Plague and Bioterror

Bioterrorism is a real threat to the United States and around the world. Although the United States does not currently expect a plague attack, it is possible that pneumonic plague could occur via an aerosol distribution. The Y. pestis bacterium is widely available in microbiology banks around the world, and thousands of scientists have worked with plague, making a biological attack a serious concern.

NIAID Research

The National Institute of Allergy and Infectious Diseases (NIAID) supports research on the diagnosis, prevention, and treatment of infections caused by microbes, including those that have the potential for use as biological weapons. The research program to address biodefense includes both short- and long-term studies targeted at designing, developing, evaluating, and approving specific tools (diagnostics, therapies, and vaccines) needed to defend against possible bioterrorist-caused disease outbreaks.

Current research projects include identifying genes in the Y. pestis bacterium that infect the digestive tract of fleas and researching how the bacterium is transferred to humans, studying the disease-causing proteins and genes of Y. pestis that allow the bacterium to grow in humans and how they function in human lungs.

NIAID is also working with the U.S. Department of Defense, the Centers for Disease Control and Prevention, and the Department of Energy to develop a vaccine that protects against inhalationally acquired pneumonic plague, develop promising antibiotics and intervention strategies to prevent and treat plague infection.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.