What is plague?
Plague is a communicable disease that affects rodents, some animals and humans. It is caused by the bacteria Yersinia pestis. There are three main forms of plague infection: bubonic, pneumonic and septicaemic. Plague in human is a serious disease with a case-fatality ratio of 30% – 60% for the bubonic type, and is always fatal for the pneumonic type when left untreated.
Mode of transmission
Plague is transmitted from an infected animal (mainly rodent) to humans through the bite of infected animal's fleas. People can also contract plague when cuts or other breaks in their skin come into contact with the body fluid or tissue of infected animals, or through inhalation of infected respiratory droplets. Bubonic plague is not usually transmitted directly from person to person unless there is contact with pus from suppurating buboes. Pneumonic plague is highly contagious. It can spread between humans by inhalation of respiratory droplets from an infected person.
The incubation period of bubonic plague is usually 2 – 6 days while the incubation period for primary pneumonic plague is usually 1 – 4 days.
Patients with bubonic plague typically experience a sudden onset of illness characterised by headache, shaking chills, fever, malaise and painful swelling of the affected regional lymph nodes. The swollen lymph node is called a ‘bubo’. This is the common form of plague and is termed bubonic plague.
The infection can progress to septicaemic plague when the bacteria invade the blood stream. The infection can be spread to other organs and cause serious complications.
Patients with pneumonic plague typically present with chills, fever, headache, body pains, weakness and chest discomfort, cough with blood-stained sputum, difficulty in breathing and may die rapidly if not treated immediately. The patient is highly infectious in this most serious form of plague.
Plague patients should be isolated and treated with appropriate antibiotics.
Plague endemic areas
As an animal disease, plague is found in all continents, except Oceania. Plague epidemics have occurred in Africa, Asia and South America. Since the 1990s, most human cases have occurred in Africa. The three most endemic countries are the Democratic Republic of Congo, Madagascar and Peru.