The Plague In Modern Times

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There are a number of pandemic-potential diseases that are under relatively good control now, at least in developed countries. Smallpox comes to mind as an infection that killed millions in the past but is now essentially eradicated. Some illnesses still exist as epidemics in certain regions, such as Malaria. Others, pop up sporadically but can still be a threat in a long-term disaster setting. One of these is the Plague.
Plague has been responsible for many deaths in the past in Europe and Asia, and is still an issue in Africa today. In the U.S., several plague cases are reported every year. Recently, a young man in Colorado contracted the disease and died within 4 days. What, then, should you know about this disease?


The Plague is a bacterial infectious disease caused by the organism Yersinia Pestis. The microbe lives in the intestinal tract of fleas that infest rodents. These fleas have been found on:
• Rats
• Squirrels
• Rabbits
• Prairie dogs
• Chipmunks

Infections begin when a person is bitten by a flea that has been infected. This occurs when it bites a rodent that was previously bitten by another disease-carrying flea. The bacteria multiplies in the flea’s guts and form a stomach-blocking plug. The flea starves but continues to try to feed; this causes the flea to vomit, spilling blood and bacteria into the bite wound when it attacks a human. The flea dies of starvation and the rodent and human, if untreated, die of the Plague.


There are several different types of plague. The three main types are:
Bubonic plague: Bubonic plague, the most common form, is named after swollen lymph nodes called “buboes” which develop within a few days of infection. These buboes are filled with bacteria, blood, and pus, and are usually found in the groin, neck, and armpit. Warm to the touch, these painful swellings can reach the size of an egg. Fever, fatigue, head and muscle aches are other symptoms you might see in a patient with bubonic plague.

Septicemic plague: Bacteria may pass from buboes into the bloodstream, or may directly enter the body through an open wound. Besides fever and other general symptoms, toxins produced by Yersinia Pestis cause a blood abnormality called DIC (disseminated intravascular coagulation). In DIC, clots occur throughout the body and may block circulation to areas, causing tissue death (gangrene). Once the body depletes all its clotting factors, bleeding is unstoppable and occurs spontaneously into the skin, lungs, and other organs. Death may occur the same day.

Pneumonic plague: Plague bacteria may enter the lungs through air droplets, causing headache, weakness, and difficulty breathing. The victim initially appears like they have a severe flu, but the disease rapidly progresses to vomiting or coughing up of blood (called “Hemoptysis). If untreated, death occurs quickly. As it is airborne, pneumonic plague is extremely contagious.
Bubonic plague carries a 50% death rate, while septicemic and pneumonic plague are almost always fatal if not treated.


Certain circumstances increase the risk of contracting the Plague. These include:

  • Contact with animals, especially rodents, that may have fleas with the bacteria.
  • Rural living or wilderness activities, especially during the Summer.
    In the U.S., living in the Western part of the country.

Crowded, unsanitary conditions are another major risk factor for Plague, and is the reason why it still exists in significant numbers in some African countries.


Before the advent of antibiotics, no. Today, however, most people survive if they’re given the correct drugs early. Plague can be treated with Doxycycline, Ciprofloxacin, Levofloxacin, or intravenous Gentamycin. As yet, no effective vaccine exists. For survival purposes, Doxycycline and Ciprofloxacin are available in veterinary form.


Good hygiene and sanitation help prevent plague outbreaks, which mostly occur in dirty, crowded, and rat-infested areas. In normal times, you can prevent plague by keeping pets free of fleas,  using insect repellant when outdoors, and taking measure to rodent-proof your home or retreat.

Never underestimate the importance of maintaining good hygiene and keeping your home clean to prevent Plague and many other illnesses.

For my article on rodent-proofing, click the link below:
Joe Alton, MD


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