When talking about the plague, images of the Middle Ages inevitably become infested with unhygienic conditions, countless rats and many deserted regions - after all, the plague epidemics in the Middle Ages claimed more than 20 million lives. But even today, the plague bacteria are deadly for 1, 000-3, 000 people a year, most recently the lung plague that broke out in northwest China.

Pest - what is it?

The plague is a bacterial disease that can be very different: in the worst case, it leads to lung death within a few days to death, the harmless variant leads to a slight flu reaction of the body with some fever and malaise (abortive pest form). The plague bacteria can be transmitted to humans through bites of an infected flea or be passed on as a droplet infection, for example when coughing from human to human.

How often do you have pestilences and where do they occur?

While Europe and Australia are considered to be free of pests, there are areas in Asia, Africa and America where regional plague outbreaks occur time and again. Endangered by all people who have a lot of direct contact with animals: hunters, veterinarians, but also shepherds or other people who live together with their animals cramped. Especially in poor hygienic conditions and in areas with a low standard of living, in which many people - and also animals - live together in a confined space, infected fleas can also infect humans in addition to rats and other rodents. Although the conditions for the worldwide spread of a herd of infection as in the Middle Ages are not given, but it comes locally every year to limited pest outbreaks, which sometimes require several hundred or even a thousand deaths. The countries of Uganda, Congo, India and China have been affected in recent years - but also in the southwest of the United States there are sometimes plague diseases in cat owners, whose animals capture diseased prairie dogs.

Bubonic plague, pulmonary plague - where is the difference?

The different pest forms are actually caused by the same pathogen. In the case of bubonic plague, local lymphatic swelling of the lymph nodes occurs locally at the bite site - the lymph nodes and pathways can form bulges of up to 10 centimeters in thickness (hence the name). On the other hand, the plague sufferer shows strong fever, flu symptoms, possibly unconsciousness. The bubonic plague is often in a Pestsepsis (sepsis = blood poisoning), in which the bacteria are scattered with the blood in all organs, where they lead to disease symptoms. While a bubonic plague is fatal in about half of all illnesses, plague sepsis without targeted antibiotic treatment is almost always fatal - after just 1 to 2 days.
The clinical picture of the lung plague is similarly fatal. Even there, up to 95% of all patients die within a few days - probably because the direct contact of the pathogens with the lungs also makes it possible for the body's immune system to fight the infection too late. Those affected cough, develop after a short time bloody sputum and a lung failure with shortness of breath and blood back pressure to the heart. Sometimes, the plague also begins with a sore throat, which, however, like the bubonic plague without treatment can degenerate into a plague sepsis. Only the abortive plague is a harmless variant associated with mild cold symptoms. If you have survived a plague attack, there is lifelong immunity to this dangerous disease.

What can one do with a plague disease?

If a plague disease is suspected, the rapid administration of antibiotic substances such as streptomycin, tetracycline or doxycycline is usually life-saving - which can lower mortality to below 20%. The detection of the pathogens in the blood ensures the diagnosis, but is usually started because of the dramatic disease course of treatment before a result is available.
In addition, the destruction of infected fleas by means of insect killers and the control of rodents in the affected areas plays a special role. These measures prevent further persons from becoming infected with the pathogens.

How to prevent a pestilence?

Protective measures against flea-bites in areas known for plague outbreaks, such as leg-covering and modern insect repellents, are as much a matter of course for people living in vulnerable areas as rodents are. If you are possibly in contact with the pathogens, a precautionary antibiotic treatment over several days is recommended. Although there is a vaccine against the Pesterreger, but it is only limited effective and poorly tolerated.

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