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Septicemic Plague

more about Septicemic Plague

Plague, Bubonic Plague, Pneumonic Plague, or Black Death

  • Plague is an infection transmitted from rodents to humans by fleas.  An infected flea bites a human, transmitting the disease.  This disease can also be transmitted by accidentally ingesting flea feces, or from someone with Pneumonia (Lung Infection) via coughing, thereby passing Plague bacteria to another person.
  • The disease is present in third world countries and is endemic (i.e., present at all times) in the southwestern United States (California, New Mexico, Nevada, Arizona, and Utah).  Plague is rare in areas with good sanitation and rodent population control.

  • Symptoms appear 2-10 days after exposure
  • BP (Bubonic Plague):
    1. High Fever
    2. Chills
    3. Headache
    4. Weakness
    5. Muscle ache
    6. Joint ache
    7. Poor appetite
    8. There may be reddened areas, pus, fluid-filled sacs (Vesicles), or burn-like slough (eschar) where the flea bite occurred.
    9. Buboes in the groin, armpits, neck, and other sites.
    10. Buboes can get as large as eggs.
    11. Black-purple spots can appear under the skin.
    1. Symptoms of BP (can occur without BP symptoms)
    2. Seizures
    3. Shock
    4. Confusion
    5. Bleeding tendency
  • PP (pneumonic plaque):
    1. With BP or SP
    2. Symptoms occur within hours-one day after inhalation of bacteria
    3. Cough
    4. Frothy sputum (what is coughed up)
    5. Coughing blood
    6. Chest pain
    7. Shortness of breath
    8. Confusion.
    9. Bluish tinge to skin and lips (cyanosis)
    10. Shock
    11. Death

  • Bacteria-Yersinia pestis causes the so-calledBubonic Plague (BP), which is characterized by buboes, swollen lumps that are reddened, smooth, painful, and tender.  These lumps are swollen lymph nodes that act as a filter to keep bacteria and other invaders out of the blood stream.
  • The bacteria can spread to the blood (septicemic Plague, SP) and the lungs (pneumonic Plague, PP).
  • Infected cats can also transmit the bacteria by scratching or biting humans.

  • History of exposure
  • Medical evaluation:
    1. Physical signs of infection (i.e., buboes)
    2. Low Blood Pressure
    3. High fever
    4. Rapid heart rate
    5. Rapid breathing
    6. Bluish lips and skin
    7. Swollen lymph nodes
    8. Liver and spleen may be enlarged.
  • Tests:
    1. Blood, urine, sputum, and fluid from buboes or other lesions are collected and sent immediately to a laboratory where the bacteria is grown and identified (cultures).
    2. The secretions from buboes, sputum, and blood can also be stained with a dye (gram stain).  When examined under a microscope, it will show the bacteria (Y. pestis).
    3. Blood samples will show an elevation of the number of white blood cells (body's soldiers) low number of platelets (cells that stop bleeding), and low oxygen levels.
    4. Biopsy or sample of the buboes will show the bacteria.
    5. Chest X-Ray will show patchy areas in the lungs in PP.
    6. Echocardiography uses sound waves to generate a picture to show fluid around the heart (seropurulent Pericarditis).
    7. Spinal fluid is removed (spinal tap) if spread of infection to the membrane covering the brain is suspected.
    8. Public health authorities will need to be notified if a diagnoses of the Plague is confirmed.

  • Third world countries where rodent population is out of control
  • Skinning wild animals
  • Workers in laboratories where Y. pestis is grown
  • Healthcare workers taking care of patients with pneumonic Plague
  • War zones
  • Famine

  • Admit to hospital.
  • Isolate from other patients for 48 hours after effective therapy is started or cultures are negative.
  • Gloves must be worn at all times when in contact with the infected individual.
  • Avoid contact with all bodily fluids (urine, sputum, saliva, blood, and sperm).
  • Fluids are given intravenously-IV (via the veins)
  • Oxygen may be needed.
  • If in Shock or having Seizures, appropriate medications are given.
  • Antibiotics IV such as Streptomycin or Gentamicin are given.
  • Rarely, if patient is not too sick, antibiotic pills such as Tetracycline can be used.
  • If the heart stops or the patient cannot breath (or stops breathing), start CPR and put him on a respirator (breathing machine) immediately.

  • Plague spreads very rapidly and can be fatal.  Avoid all contact with infected rodents and patients.  Immediate treatment and notification of authorities is a must.  The faster one gets treatment, the better the chances of survival.

  • Infections:

    1. Meningococcemia
    2. Rickettsial infections
    3. Typhoid Fever
    4. Tularemia
    5. Lymphogranuloma venereum
    6. Bacterial Sepsis or Pneumonia
    7. Syphilis

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