Bubonic Plague Claims US Man's Life: Check For Symptoms, Treatment Options, Prevention

In bubonic plague, Y. pestis enters the body at the site of the bite, and travels through the lymphatic system to the nearest lymph node where it 'replicates' itself. The lymph node becomes 'inflamed', 'tense' and 'painful', and is called a 'bubo'.

Has the bubonic plague made a comeback? This is the question that has been making people uneasy in the US, where the ancient disease has already claimed one life. According to news reports, a man in New Mexico succumbed to the plague, making it the first human death from the disease in the state since 2020. The New Mexico Department of Health announced last week that the deceased -- whose identity remains unknown -- was hospitalised after contracting the disease; he passed away in the hospital. According to the Centers for Disease Control and Prevention (CDC), the plague affects humans and other mammals, and is caused by the bacterium 'Yersinia pestis'. Humans usually get it after being bitten by a rodent flea carrying the plague bacterium or by handling an animal infected with plague.

Key Facts About The Plague

According to the World Health Organization (WHO), here are some important things about the plague that one must know:

1. People infected with Y. pestis develop symptoms after an incubation period of 1 to 7 days.
2. There are two main clinical forms of plague infection: bubonic and pneumonic. Between the two, bubonic plague is the most common form, characterised by painful swollen lymph nodes or 'buboes'.
3. The plague is transmitted between animals and humans by the bite of infected fleas, direct contact with infected tissues, and/or inhalation of infected respiratory droplets.
4. Plague can be a 'very severe' disease in people, with a case-fatality ratio of 30 per cent to 60 per cent for the bubonic type.

History Of The Plague

According to the National Institutes of Health (NIH), the bubonic plague or the 'Black Death' was one of 'mankind's worst pandemics' that killed more than 25 million people or at least one third of Europe's population during the 14th century. It continues to remain endemic in some parts of the world. The WHO warns that currently the three most endemic countries are the Democratic Republic of the Congo, Madagascar, and Peru.

Transmission

Per the WHO, it is transmitted between animals through fleas, and humans can be infected through:

• The bite of infected vector fleas;
• Unprotected contact with infectious bodily fluids or contaminated materials;
• The inhalation of respiratory droplets/small particles from a patient with pneumonic plague.

Symptoms

People infected with plague usually develop sudden onset of fever, chills, head and body aches, and weakness, vomiting and nausea, states WHO.

Difference Between Bubonic Plague And Pneumonic Plague

The WHO explains that in bubonic plague, Y. pestis enters the body at the site of the bite, and travels through the lymphatic system to the nearest lymph node where it 'replicates' itself. The lymph node becomes 'inflamed', 'tense' and 'painful', and is called a 'bubo'. At an advanced stage, the inflamed lymph nodes can turn into 'open sores filled with pus'. It should be noted that human-to-human transmission of bubonic plague is rare, but when it advances and spreads to the lungs, it leads to the 'more severe type of plague' called pneumonic plague.

Diagnosing The Plague

The process entails lab testing. Experts look at a sample of pus from a bubo, blood or sputum to detect a specific Y. pestis antigen.

Treatment

The WHO warns that untreated pneumonic plague can be 'rapidly fatal'. Antibiotics and supportive therapy are effective if patients are diagnosed in a timely manner. "Pneumonic plague can be fatal within 18 to 24 hours of disease onset if left untreated, but common antibiotics for enterobacteria (gram negative rods) can effectively cure the disease if they are delivered early," the WHO website states.

Prevention

It is important to raise awareness and inform people when zoonotic plague is present in their environment. They must take precautions against flea bites and not handle animal carcasses, WHO advises. In addition to that, people should also be advised to avoid direct contact with infected body fluids and tissues, and when handling potentially-infected patients and collecting specimens, maintain standard precautions.