Pneumonic plague, a severe type of lung infection, is one of three main forms of
plague, all of which are caused by the bacterium Yersinia pestis. It is more
virulent and rarer than bubonic plague. The difference between the versions of
plague is simply the location of the infection in the body; the bubonic
plague is an infection of the lymphatic system, the pneumonic plague is an
infection of the respiratory system, and the septicemic plague is an infection in
the blood stream. Typically, the pneumonic form is due to
a spread from infection of an initial bubonic form. Primary pneumonic plague
results from inhalation of fine infective droplets and can be
transmitted from human to human without involvement of fleas or animals.
Untreated pneumonic plague has a mortality rate from 90-100%.
Signs and symptoms The most apparent symptom of pneumonic
plague is coughing, often with hemoptysis. With pneumonic plague, the
first signs of illness are fever, headache, weakness and rapidly
developing pneumonia with shortness of breath, chest pain, cough and sometimes
bloody or watery sputum. The pneumonia progresses for two to four
days and may cause respiratory failure and shock. Patients will die without
early treatment, some within 36 hours. Initial pneumonic plague symptoms can
often include the following: Fever
Weakness Headaches
Nausea Rapidly developing pneumonia with:
Shortness of breath Chest pain
Cough Bloody or watery sputum.
Pathology and transmission Pneumonic plague can be caused in two
ways: primary, which results from the inhalation of aerosolised plague
bacteria, or secondary, when septicaemic plague spreads into lung tissue from the
bloodstream. Pneumonic plague is not exclusively vector-borne like bubonic
plague; instead it can be spread from person to person. There have been cases
of pneumonic plague resulting from the dissection or handling of contaminated
animal tissue. This is one type of the plague formerly known as the Black
Death. Prognosis and treatment
Pneumonic plague is a very aggressive infection requiring early treatment.
Antibiotics must be given within 24 hours of first symptoms to reduce the
risk of death. Streptomycin, gentamicin, tetracyclines and chloramphenicol are
all effective against pneumonic plague. Antibiotic treatment for seven days will
protect people who have had direct, close contact with infected patients.
Wearing a close-fitting surgical mask also protects against infection.
The mortality rate from untreated pneumonic plague approaches 100%.
Epidemiology Since 2002, the World Health
Organization has reported seven plague outbreaks, though some may go unreported
because they often happen in remote areas. Between 1998 and 2009, nearly
24,000 cases have been reported, including about 2,000 deaths, in Africa,
Asia, the Americas, and Eastern Europe. Ninety-eight percent of the world's
cases occur in Africa. = India =
In September of 1994, India experienced an outbreak of plague that killed 50 and
caused travel to New Delhi by air to be suspended until the outbreak was brought
under control. The outbreak was feared to be much worse because the plague
superficially resembles other common diseases such as influenza and
bronchitis; over 200 people that had been quarantined were released when they
did not test positive for the plague. All but two of the deaths occurred
around the city of Surat. = China =
The People's Republic of China has eradicated the pneumonic plague from
most parts of the country, but still reports occasional cases in remote
Western areas where the disease is carried by rats and the marmots that
live across the Himalayan plateau. Outbreaks can be caused when a person
eats an infected marmot or comes into contact with fleas carried by rats. A
2006 WHO report from an international meeting on plague cited a Chinese
government disease expert as saying that most cases of the plague in China's
northwest occur when hunters are contaminated while skinning infected
animals. The expert said at the time that due to
the region's remoteness, the disease killed more than half the infected
people. The report also said that since the 1990s, there was a rise in plague
cases in humans—from fewer than 10 in the 1980s to nearly 100 cases in 1996
and 254 in 2000. Official statistics posted on the Chinese Health Ministry's
Web site showed no cases of plague in 2007 and 2008. In September 2008, two
people in east Tibet died of pneumonic plague.
A recent outbreak of the disease in China began in August 2009 in Ziketan
Town located in Qinghai Province. The town was sealed off and several people
died as a result of the disease. According to spokesperson Vivian Tan of
the WHO office in Beijing, "In cases like this [in August 2009], we encourage
the authorities to identify cases, to investigate any suspicious symptoms
among close contacts, and to treat confirmed cases as soon as possible. So
far, they have done exactly that. There have been sporadic cases reported around
the country in the last few years so the authorities do have the experience to
deal with this." In September 2010, five cases of
pneumonic plague were reported in Tibet. In July 17, 2014, Chinese media reported
one case found in Gansu. = Peru =
In August 2010, Peru's health minister Oscar Ugarte announced that an outbreak
of plague had killed a 14-year-old boy and had infected at least 31 people in a
northern coastal province. The boy died of bubonic plague on 26 July 2010.
Ugarte stated that authorities were screening sugar and fish meal exports
from Ascope Province, located about 325 miles northwest of Lima, not far from
popular Chicama beach. Most of the infections in Peru were bubonic plague,
with four cases of pneumonic plague. The first recorded plague outbreak in
Peru was in 1903. The last, in 1994, killed 35 people.
= Madagascar = An outbreak of plague in November 2013,
occurred in the African island nation of Madagascar. As of 16 December, at least
89 people were infected, with 39 deaths with at least two cases involving
pneumonic plague. However, as many as 90% of cases were later reported to have
involved pneumonic plague. The WHO and Institut Pasteur were both involved in
administering antibiotic compounds and attempting to stop the spread of the
disease. = United-States =
On November 2, 2007, wildlife biologist Eric York died of pneumonic plague in
Grand Canyon National Park. York was exposed to the bacteria while conducting
a necropsy on a mountain lion carcass. On July 10, 2014, in an online news
story article, by Keith Coffman of Reuters, featured on the MSN U.S. News
website, it was stated that a Colorado man, whose condition the report said was
not known, had been diagnosed with the pneumonic plague. The man was found to
have the disease after the family dog died unexpectedly and a necropsy
conducted on it revealed it had died from the disease, which is spread when
fleas which have been hosted by rodents spread to another nearby host once the
original one dies. The plague is found in the western U.S., according to the
CDC. As of July 18, 2014, three more cases
were reported in Colorado. However, the outbreak appears to be over, according
to state officials. The outbreak was caused by a pit bull.
See also Bubonic plague
Septicemic plague References
External links Facts about Pneumonic Plague. Centers
for Disease Control and Prevention.[[de:Pest#Lungenpest]