Plague

In plague (theasaurus synonyma: bubonic plague; bubo caused by Yersinia pestis; bubonic plague; skin plague; infection caused by Pasteurella pestis; infection caused by Yersinia pestis – cf. Plague; pneumonic plague; meningitis due to Yersinia pestis; plague bacterial infection; plague fever; plague; pestis fulminans; pestis minor; pestis siderans; pestmeningitis; plague pneumonia; plague sepsis; Pharyngeal plague; pneumonia due to Yersinia pestis; primary pneumonic plague; primary plague pneumonia; secondary pneumonic plague; secondary plague pneumonia; sepsis due to Yersinia pestis; tonsillar plague; ICD-10 A20. ) is an infectious disease caused by the gram-negative bacterium Yersinia pestis from the Enterobacteriaceae family.

The disease is one of the bacterial zoonoses (animal diseases).

The natural reservoir of the plague bacterium is rodents, especially rats, and their fleas.

Occurrence: Plague still occurs today, in limited areas, in Asia, Mongolia, South Africa, Kenya and Tanzania, Madagascar, northern Africa, Central/South America (tropics), North America (Yosemite National Park). In Germany, imported cases occur extremely rarely.

The plague is highly contagious (highly infectious)!

Transmission of the pathogen (route of infection) to humans occurs through flea bites, scratches and bites by infected cats, contact with infected animal carcasses, exposure to aerosols, eating infected animals (e.g. guinea pigs in Peru and Ecuador or goats and camels in Libya or marmots in Mongolia). Furthermore, transmission is possible through contact with persons infected with pneumonic plague.

Human-to-human transmission: Depends on the form. In bubonic plague, human-to-human transmission is not possible. Pneumonic plague is characterized by rapid human-to-human spread.

The incubation period (time from infection to onset of disease) is usually 1-7 days; primary pneumonic plague has a very short incubation period of a few hours to days.

The following forms of infection can be distinguished:

  • Bubonic (bubonic) plague (A20.0) – most common form; transmitted by a bite from an infected flea; can lead to pneumonic plague or plague sepsis by spread of the causative agent; plague minor with only one bubonic (A20.8)
  • Plague sepsis (A20.7) – generalized form of infection caused by spread of the pathogen
  • Pneumonic plague (A20.2) – rarest form.
  • Other forms such as cutaneous plague (A20.1), plague meningitis (meningitis; A20.3), abortive plague (A20.8)

Course and prognosis: The prognosis depends on the form of plague and how early therapy was started. If left untreated, the disease is lethal (fatal). If left untreated, plague sepsis has an extremely high lethality (mortality in relation to the total number of people infected with the disease) of 95%.

Vaccination: Vaccination against plague is available but not recommended by public health authorities.

In Germany, even the suspicion of infection is reportable by name under the Infection Protection Act (IfSG).