plague by dr. shah yaseen suhail

8/14/2019 Plague by Dr. shah yaseen suhail

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PLAGUEPLAGUE

DR. YASEEN SUHAIL SHAH


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12/16/08By Dr Yaseen Suhail Shah 2

doctors maskdoctors mask

doctors mask

This is called as doctors mask,used by those doctors who workwith plague patients.


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Plague is a term applied to an infectiousdisease that spreads easily and, without

antibiotics treatment, can be fatal.


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The plague has caused more fearandterror than perhaps any other

infectiousdisease in history. It has killednearly

200 million people and hasproduced


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HISTORY

The plague has been responsible formultiple epidemics and at least 3 greatPandemics.

The first plague pandemic spannedfrom the Middle East to theMediterranean basin during the 5th

and 6th centuries, killing about halfthe population of those areas..


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The second pandemic struckEurope between the 8th and 14thcenturies, destroying nearly 40% of

Europe's population.The third pandemic started in 1855in China and spread to every major

continent.


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Aleixandre Yersin isolated the bacterium (germ)that causes plague, developed a treatment(an antiserum) to combat the disease, andwas the first to suggest that fleas and rats

may have been spreading plague during theepidemic of 1894.

The plague bacillus(bacterium) was named

Yersinia pestis in Yersin's memory.



Plague CausesThe bacteria that cause plague can be transmittedfrom a host such as a rat to a human through thebite of an animal or insect (such as a flea).These bites transport the disease. The animal orinsect that spreads the disease is referred to as aVector.



A hungry flea filled with plague bacteria.



More than 200 different rodents and other speciescan serve as hosts. Hosts can include domesticcats and dogs, squirrels, chipmunks, marmots,deer mice, rabbits, hares, rock squirrels, camels,

and sheep.The vector is usually the rat flea. Thirty differentflea species have been identified as carriers of theplague. Other carriers of plague include ticks and

human lice.



Rock squirrel coughing the blood-

streaked sputum of pneumonic plague.



People infected by pneumonic plaguecan transmit air-borne plague in the

form of coughed droplets. Closecontact with plague-infected tissue orfluid can also transmit plague.



TYPES OF PLAGUE

Bubonic plague:Bacteria that cause plague can thrive and grow in thefleas esophagus. This crowding of bacterial growth

prevents food from entering the fleas stomach.To overcome starvation, the flea begins a blood-sucking rampage. Struggling to swallow, the fleavomits the plague-causing bacteria into the victim skinduring a bite. The germs invade nearby lymph glands in

the bitten animal and produce an inflamed lymph nodecalled a bubo. The plague spreads along the lymphSystem to every organ. In rare cases, plague spreadsto the covering of the brain. Severe illness follows.



Pneumonic plague:Direct inhalation of the plague-causing germsresults in pneumonic plague. Severe illnessfollows. The death rate for pneumonic plagueis 100% if not treated within the first 24 hoursof infection. Plague bacteria may be released

into the air as a weapon of biological warfareor terrorism causing this type of the disease,or plague may be contracted through theinhalation of droplets coughed from the lungsof a person with pneumonic plague.



Septicemic plague:

This form causes severe blood infectionthroughout the body. It may occur quickly ifa person is bitten in the mouth or throatarea (primary). This type of plague can also

develop from one of the other types ofplague (secondary). Septicemic plague has a40% death rate in treated cases and 100% inuntreated cases.



Risk factorsThe following conditions may increase thelikelihood of a person contracting a plagueinfection.

Living in a rural area and especially in areaswhere plague is common

Having contact with sick animals, smallrodents, or other possible hostsParticipating in wilderness activities (suchas camping, hiking, sleeping on the ground,hunting)Exposure to flea bitesExposure to naturally occurring plague inthe community



Travel: Although contracting plague while visiting anothercountry is rare, doctors may suspect that a flea might havebitten a patient with plague like symptoms who hasrecently traveled abroad to areas where plague is present.Fewer than 10% of flea-bitten people remember a fleahaving bitten them.

Animal contact: Close contact with infected animals andtravel through rural areas are risk factors for contractingplague. Historically, rats have been the principal hosts of

the plague. Currently rock squirrels are the most commonhosts. In recent years, the domestic cat has emerged as aprominent host of fleas that transmit the plague toveterinarians.



Plague Signs and SymptomsCommon general symptoms

FeverChillsBody achesSore throatHeadacheWeaknessGeneral feeling of illnessAbdominal pain (may be the only symptomfor someone with septicemic plague)

Nausea, vomiting (sometimes containingblood)Constipation, diarrhea, and black or tarrystools



Stomach pains (may precede a bubo)Cough (may contain blood)Shortness of breath

Stiff neckFever, heart irregularities, low blood pressureConfusion, seizures (later in the infection)Bubo: This is an enlarged, tender, swollen lymph

gland most commonly found in the groin, under thearms, or on the neck, depending on the locationsof the flea bite.Skin: Bleeding into the tissues can turn tissueblack. This is why the plague is also referred to asblack death. The medieval rhyme "black death" isthought to have originated from the deeplydarkened skin, bleeding, and tissue deathassociated with septicemic and pneumonic plague.


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The "black death."A victim recovering from bubonic plague. At one

time this person's entire body was black.


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The same plague victim as previous photo. Thetoes have gangrene and will probably need to beamputated.


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The initially rose-colored lesions most likelyinspired the child's nursery rhyme "Ring Around

the Rosy.""Ring around the rosy" - Rose-colored areasof skin"Pocket full of posies" - Sweet-smelling flowersthat those tending the sick would carry to wardoff the stench of disease"Ashes, ashes" - Impending death (or "A-choo,a-choo" - The sneezing and coughing of thosewith pneumonic plague)"All fall down" Death


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Physician DiagnosisIn making the diagnosis,Blood tests such as cultures (growing the

bacteria in the lab from samples of blood, sputum,and fluid from the bubo). Cultures require morethan 48 hours to produce definitive results.X-ray film of the chest, especially to see if plague

has infected the lungs.The Centers for Disease Control and Prevention(CDC) may test samples with more sophisticatedprocedures.


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Plague TreatmentIf doctors suspect a patient may have plague, all healthcare personnel take precautions. They wear goggles,gloves, gowns, and possibly masks.Patients are isolated and all precautions taken not toinfect others.Some patients may need oxygen. They are kept awayfrom others for 2-3 days after antibiotic treatment has

started or until the infection is cleared.Most patients experience some degree of septic shock(blood infection/poisoning), and specialists monitor thisclosely in an intensive care unit.Medical management of plague can involve a number of

medications. Antibiotics must be given early. These mightinclude streptomycin sulfate in combination withtetracycline and other antibiotics.


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PrognosisPatients with plague may develop meningitis

(infection and swelling of the brain), septic shock(a serious system wide blood infection), tissuedeath and bleeding, and swelling around theheart. All may lead to death.The death rate is 1-15% for those treated forbubonic plague.A person with primary or secondary Septicemicplague (infection is active in the bloodstream andthe patient has shock symptoms) has a 40%death rate, even when treated.Pneumonic plague has 100% death rate if nottreated within the first 24 hours.


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plague by dr. shah yaseen suhail

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