A primer on the plague

August 3, 6:54 PMBaltimore Health ExaminerDr. Delia Chiaramonte

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The Plague has reared its ugly head again.  In rural China 2 people have died from a particularly virulent form of plague and Chinese officials have responded by closing off roads into and out of the affected region. 

Should we be worried?

Many people mistakenly believe that plague has been eradicated.  In reality, according to the CDC, scattered cases occur in the U.S. every year, particularly in New Mexico, Arizona, Colorado, California, Oregon and Nevada.  The World Health Organization reports 1,000 to 3,000 global cases of plague annually.

Plague is caused by a bacterium, Yersinia pestis, that infects rodents, fleas and occasionally humans.  Symptoms occur up to a week after infection and include fever, chills, body aches and vomiting. 

There are three forms of plague that present differently based on the mode of infection: bubonic, septicemic, and pneumonic.

•    Bubonic plague follows the bite of an infected flea.  The bacteria travel through the lymphatic system and reproduce actively in nearby lymph nodes, causing a painful “bubo” which can become an open sore.

•    Septicemic plague occurs when the bacteria bypass the lymph nodes and travel directly into the bloodstream. 

•    Pneumonic plague can be transmitted directly from person to person via respiratory droplets.  It is the most virulent form of plague and is frequently fatal.  It is this form of plague that has affected the patients in China.

Plague, while dangerous and frightening, can be fairly easily treated. Commonly used antibiotics such as gentamicin, tetracycline and sulfa drugs are effective if started immediately.  Those who have been exposed to a patient with pneumonic plague or to potentially infected fleas can take prophylactic antibiotics to prevent active infection.  There is no vaccine available in the United States.

So should you be worried?  Not unless you live in Ziketon, China or make a habit of playing with wild, flea-ridden rodents.  But if one day you are hiking in Colorado and find a bunch of dead rats, I would suggest that you walk quickly in the other direction.

Be well,

Dr. Chiaramonte

For more information visit the CDC website