Plague

Plague's disease overview

Plague is a infectious disease caused by Yersinia Pestis bacteria. Acute progressive disease with manifestation of severe bacterial infections. People infected with pathogenic bacteria from rodents such as rabbits, rats, ... through intermediaries are infected fleas. In Vietnam, the pathogenic vector is Xenopsylla Cheopis parasitic parasite mainly on mice. 

Clinically

plague is divided into many forms, including: lymphadenopathy, lung, brain and bacterial infection; In which the lymph nodes account for the majority with the rate of more than 90%. Dry weather is a condition suitable for the development of mice and fleas, which is also the time when the plague is the strongest outbreak. However, the plague is still recorded in other times of the year.

Plague circulates in many countries and regions in the world. From 1989-2003, 2,845 deaths were recorded in 38,310 cases from 25 countries around the world. The disease causes many terrible pandemic, robbing the lives of hundreds of millions of people around the world. In Vietnam, from 1960-1970, there are about 10,000 cases of disease each year, leading the world. The number of cases decreased sharply to about 140 cases per year in the following years. So far, almost no plague cases are not recorded in medical facilities.

People with plague can obtain immunity after healing. However, this immunity is only relative, not protecting the patient at the attack of a large amount of bacteria.

Causes of Plague's disease

The cause of the disease is the plague bacteria called Yersinia Pestis. This is a kind of gram -negative bacillus, belonging to the Enerobacteriaceae family. Plague bacteria can be destroyed at a temperature of 550C for 30 minutes, at 1000C for 1 minute and destroyed by common disinfectant. Yersinia Pestis was named after the discovery of it as a French doctor Alexandre Yersin.

Symptoms of Plague's disease

Symptoms of plague different by clinical form.

lymphoma

This is the most common disease.  

  • The average incubation period is about 2-5 days, which can last from a few hours to 8-10 days, the patient has no clinical manifestations.
  • At the stage of onset, the patient is healthy suddenly feeling tired, headache, dizziness, nausea, high fever, cold tremor, pain throughout the body, pain Many in the site of the lymphadenopathy.
  • The full phase appears after a few hours or 1-2 days onset. The characteristic manifestation at this stage is lymphadenitis in places related to the area of ​​flea burning and severe poisoning infections. The lymphadenopathy is enlarged, very painful, later often turning pus and breaking itself if not treated early, flowing out of pus. The wound is long -lasting and often leaves scarring, loss of aesthetics. The most common locations are the groin, armpits, neck, under the jaw and along the sternum.

    • In the full stage of the whole body, the whole patient's body shows signs of severe infection poisoning:

  • Fever: often high fever continuously or fluctuating. The higher the disease, the higher the fever.
  • Headache, dizziness, fatigue
  • Panic, panic, can have delirium
  • Skin mucosa is congested
  • Dry lips, dirty tongue, white tongue
  • Heart beat fast
  • Quick breathing
  • Less, dark urine

    • Diarrhea Blood -infection plague

    Different from the lymph nodes, blood plaginal diseases showing poisoning infection even when peripheral lymph nodes Not inflamed. Clinical symptoms may be encountered include:

  • High fever, over 40 degrees, accompanied by chills
  • dynamic, delirium or libidies in more severe cases

    • Respiratory and cardiovascular disorders abdominal, diarrhea

  • Skin bleeding, mucosa and organs

    • The disease has a high mortality rate, dead within the first 1-2 days, called the "dark plague"

    First or secondary infections may be transmitted after the lymph node, untreated lungs are not treated.

    pulmonary plague

    The disease is very sudden after short incubation period. Symptoms of toxic infections begin to appear and get worse after just a few hours:

  • Very high fever, over 40 degrees, cold
  • Fatigue, headache
  • Quick pulse, reduced blood pressure
  • Difficulty breathing, fast breathing. Coughing a lot, sputum and blood, containing many bacteria

    • Secondary pulmonary plague after lymph nodes, bacterial infections are more common than primary lungs, with severe prognosis with high mortality rate within 1 to 2 days Head of the disease.

    skin

    Normal skin plague only has a clinical manifestation on the spot. The inlaid nodules appear at the position of bacteria invading, after progressing into blisters and pustules mixed with blood, the patient feels very painful to touch. Skin around pustules congested, infiltrated, high edges. The rupture of pustules left an ulcer with yellow -contaminated bottom, covered with black scales. These ulcers heal and slowly heal.

    Transmission route of Plague's diseasePlague

    What is the transmitted plague?

    Plague is spread by the following paths:

  • Through flea intermediaries: This is the most common path, bloody transmission and need the presence of intermediaries. Blood fleas suck the host (mouse). The bacteria that cause plague from there to multiply in the stomach of fleas clog the digestive tract. When the fleas burn the new host (people), the bacteria will follow the burning of the new host body and cause disease. Usually the spread of disease recorded from rodents like rats, rabbits, ... to humans. However, the direct spread from person to person still occurs through the flea pulex Irritans, in South Africa.
  • Directly spread: Plague can spread from the host to the healing host without the presence of intermediaries that transmit diseases such as fleas. Direct spread lines may be:

    • Respiratory: Inhalation of plague bacteria exists in the air due to contact with pulmonary plague or the host death from the plague.

    Gastrointestinal: This is a common transmission because plague bacteria are easily destroyed when boiled, cooked.

    Skin, mucous membranes: Plague bacteria can penetrate directly through both healthy skin and open skin wounds.

    People at risk for Plague's disease

    The factors that increase the risk of plague include:

  • polluted habitats, not guaranteed hygiene
  • Living in areas of plague circulating
  • Continued contact with rodents
  • The resistance of the body weakened

    • Prevention of Plague's disease

    Measures to help prevent plague:

  • Mouse removal: Periodic extermination each year from twice a year, corresponding to the mouse's reproductive period. Kill rats with chemicals like multi -dose like warfarin, brodifacou. Only use the licensed commercial forms.
  • Destroying fleas with chemicals licensed by the Ministry of Health such as Permethrin, Vectron, Diazinon.
  • When there is a plague, it is advisable to combine the flea to kill the rat. Use Kartman bait box containing powdered chemicals to combine rats and fleas. Need to check the box regularly to supplement chemicals.
  • Propaganda and educating people to perform well the environmental sanitation: traps, cat -raising cats, breaking the larch of mice; Arranging and arranging goods, especially food reasonable food.
  • Always prepare all medications, chemicals and human resources, ready to cope if the disease occurs.
  • Prevention of active disease with EV vaccine. This is a live vaccine, not high protection. EV vaccines are indicated for people living in the outbreak but no immunity or people have to move into the circulating epidemic area.
  • For those who come into contact with people with plague, they need to be closely monitored and treated for emergency treatment with: Streptomycin 1g/day x 5 days or tetracyclin 1g/day x 5 days . When patients die, corpses should be wrapped with 5%chloramine fabric, placed in the coffin sprinkled with lime powder and buried underground at a depth of 2m or cremation.

    • Diagnostic measures for Plague's disease

    To confirm the diagnosis of a case of plague, it is not only based on the mentioned clinical symptoms but also needs the coordination of subclinical tests to determine the presence of VI. bacteria. The type of specimens can be collected for testing including pus from inflammation, blood, phlegm and throat secretions, serum of mice or flea. Testing methods can be specified include:

  • Dyeing bacteria directly
  • Transplant and isolation of bacteria
  • Detect antigen F1 of plaginal bacteria

    • Immunodeficiency

    Plague's disease treatments

    Can the plague be cured?

    Plague is extremely dangerous but can be treated with available antibiotics if detected early. Treatment principle of the disease:

  • Immediately treatment when diagnosed with plague
  • Conducting the establishment of areas of isolation of patients: It may be the commune health station, the infectious department of the hospital or a separate treatment room with other treatment areas.
  • In addition to the use of specific antibiotics as directed by the doctor, it is necessary to combine with the treatment to support the whole situation.

    • Supporting treatments include:

  • Patients with plague need to be treated with all measures such as infusion, electrolyte water, adjusting alkaline acidosis, cardiovascular aids, lowering Fever, sedation.
  • Conduct positive resuscitation when the patient has manifestations of stun, respiratory failure, circulatory failure, hemorrhage ...
  • Improve resistance by providing a complete diet, lots of vitamins and minerals.

    • See also:

  • What role does the lymphadenopathy? /Li>
  • Blood infection: dangerous, silent symptoms

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