The disease of the plague, with which humanity collided more than 1,500 years ago, earlier caused large outbreaks of morbidity, taking tens and hundreds of millions of lives. The history does not know a more merciless and devastating infection , and until now, despite the development of medicine, it was not completely possible to cope with it.
What is plague?
Plague is a disease in people, which is of a natural focal infectious nature, in many cases it ends in a lethal outcome. This is a very contagious pathology, and the susceptibility to it is universal. After the transferred and cured plague, stable immunity is not formed, that is, there is a risk of re-infection (but the second time the disease is somewhat easier).
The exact origin of the name of the disease is not established, while the word "plague" in translation from Turkish means "round, cone", from Greek - "shaft", from Latin - "hit, wound". In ancient and modern scientific sources, one can come across such a definition as the bubonic plague disease. This is due to the fact that one of the distinguishing signs of the disease is bubo - a round swelling in the area of the inflamed lymph node . In this case, there are other forms of infection, without the formation of buboes.
The plague is the causative agent
For a long time it was not clear what causes the bubonic plague, the causative agent was discovered and associated with the disease only at the end of the XIX century. They turned out to be a gram-negative bacterium from the enterobacteria family - a plaque (Yersinia pestis). The pathogen is well studied, its several subspecies are revealed and the following features are established:
- can have a different form - from filiform to spherical;
- long-term preservation of viability in separated sick people;
- good tolerability of low temperatures, freezing;
- high sensitivity to disinfectants, sunlight, acid reaction of the environment, high temperatures;
- contains about thirty antigenic structures, secretes endo- and exotoxins.
Plague - ways of penetration of bacteria into the human body
It is important to know how the plague is transmitted from person to person, as well as from other living beings. Plagiarum circulates in natural infectious foci in the organisms of animal carriers, which include wild rodents (ground squirrels, groundhogs, voles), gray and black rats, house mice, cats, lagiformes, camels. The carriers (spreaders) of pathogens are fleas of different species and several types of bloodsucking ticks that are infected with the causative agent when feeding on sick animals containing plague in the blood.
Distinguish the transmission of the pathogen through fleas from animal carriers to humans and from person to person. We list the possible ways of penetrating the plague into the human body:
- Transmissible - entering the bloodstream after the bite of an infected insect.
- Contact - on contact of a person who has on the skin or mucous membranes of microtrauma, with the bodies of infected animals (for example, when cutting carcasses, processing hides).
- Almentary - through the mucosa of the gastrointestinal tract when eating meat of sick animals that have not undergone sufficient heat treatment, or other seeded products.
- Contact-household - at the touch of a sick person, contacting with his biological fluids, using dishes, personal hygiene items and the like.
- Aerosol is from person to person through the mucous membranes of the respiratory tract when coughing, sneezing, close conversation.
Plague - the symptoms in humans
From the place of introduction of the pathogen depends on which form of the disease will develop, with the damage of which organs, with what manifestations. The following basic forms of the plague of man stand out:
- bubonic;
- pulmonary;
- septic;
- intestinal.
In addition, there are such rare forms of pathology as skin, pharyngeal, meningeal, asymptomatic, abortive. The plague disease has an incubation period of 3 to 6 days, sometimes 1-2 days (with primary pulmonary or septic form) or 7-9 days (in vaccinated or already ill patients). For all forms is characterized by a sudden onset with severe symptoms and intoxication syndrome, manifested in the following:
- high body temperature;
- chills;
- headache;
- musculo-articular pain;
- nausea;
- vomiting;
- strong weakness.
As the disease develops, the appearance of the patient changes: the face becomes puffy, hyperemic, the whites of the eyes turn red, the lips and tongue become dry, dark circles appear under the eyes, the face expresses fear, horror ("plague mask"). In the future, the patient is disturbed by consciousness, speech becomes illegible, coordination of movements is disturbed, delusions and hallucinations appear. In addition, specific lesions develop, depending on the form of the plague.
Bubonic plague - the symptoms
Statistics show that bubonic plague is the most common type of disease that develops in 80% of those infected by penetrating the pathogen through the mucous membranes and skin. In this case, the infection spreads through the lymphatic system, causing damage to the inguinal lymph nodes, in rare cases - axillary or cervical. The resulting buboes are single and multiple, their size can vary from 3 to 10 cm, and in their development they often go through several stages:
- increase, hardening and soreness of the lymph nodes - a couple of days after the onset of intoxication syndrome (in the photo - bubonic plague in a patient with inguinal buboes);
- softening of bubo - on day 4 of the disease;
- spontaneous dissection, the formation of an ulcer or a zone of necrosis - on the 10th day of the plague.
Pneumonic plague
This form is diagnosed in 5-10% of patients, with the plague disease developing after aerogenic infection (primary) or as a complication of the bubonic form (secondary). This is the most dangerous variety, and the specific signs of plague in humans in this case are noted approximately on day 2-3, after the onset of acute intoxication symptoms. The causative agent affects the walls of the pulmonary alveoli, causing necrotic phenomena. Distinctive manifestations are:
- rapid breathing, shortness of breath;
- cough;
- sputum discharge - at first frothy, transparent, then - with blood veins;
- pain in the chest;
- tachycardia;
- drop in blood pressure.
Septic form of plague
The primary-septic form of the plague, which develops when a massive dose of microbes penetrates the bloodstream, is rare, but it is very difficult. Intoxicating signs appear lightning fast, as the pathogen spreads across all organs. There are numerous hemorrhages in the skin and mucous tissues, conjunctiva, intestinal and renal bleeding, rapid development of infectious-toxic shock . Sometimes this form proceeds as a secondary complication of other types of plague, which is manifested by the formation of secondary buboes.
Intestinal form of the plague
Not all specialists distinguish the intestinal variety of the plague separately, treating it as one of the manifestations of the septic form. When the intestinal plague develops signs of the disease in people against the background of general intoxication and fever, the following are recorded:
- abdominal pain;
- multiple bloody vomiting;
- diarrhea with mucocutaneous stools;
- tenesmus - painful urge to empty the intestines.
Plague - Diagnosis
Significant role played by the diagnosis of "plague" laboratory diagnosis, conducted by the following methods:
- serological;
- bacteriological;
- microscopic.
For the study take blood, punctate from buboes, separated ulcers, phlegm, separated oropharynx, vomit. To check for the presence of pathogen, the selected material can be grown on special nutrient media. In addition, an X-ray of the lymph nodes and lungs is performed. It is important to establish the fact of an insect bite, contact with sick animals or people, visit zones endemic for the plague.
Plague - treatment
If a pathology is suspected or diagnosed, the patient is urgently hospitalized in an infectious hospital in an isolated box, from which direct outflow of air is excluded. Treatment of plague in humans is based on such activities:
- reception of antibiotics, depending on the form of the disease ( Levomycetin , Tetracycline, Streptomycin);
- detoxication therapy (Albumin, Reopoliglyukin, Gemodez);
- use of drugs to improve microcirculation and repair (Trental, Solcoseryl , Pikamilon);
- antipyretic and symptomatic therapy;
- maintenance therapy (vitamins, cardiac drugs);
- plasmapheresis - with septic lesion.
During the period of fever the patient must comply with bed rest. Antibiotic therapy is carried out for 7-14 days, after which control studies of biomaterials are assigned. The patient is discharged after complete recovery, as evidenced by the receipt of a triple negative result. The success of treatment depends to a large extent on the timeliness of plague detection.
Measures to prevent plague in the human body
To prevent the spread of infection, non-specific preventive measures are carried out, including:
- analysis of information about the incidence of plague in different countries;
- identification, isolation and treatment of people with suspected pathology;
- Disinfection of transport arriving from dysfunctional regions in relation to the plague.
In addition, work is constantly carried out in natural foci of the disease: taking into account the number of wild rodents, researching them for detecting plague bacteria, destroying infected individuals, fighting fleas. In the identification of even one patient in a settlement, such anti-epidemic measures are carried out:
- the imposition of quarantine with the prohibition of entry and exit of people for several days;
- isolation of people who had contact with plague patients;
- disinfection in the foci of the disease.
People who were in contact with the sick plague, for preventive purposes, are administered anti-plague serum in combination with antibiotics. Vaccination against plague to a person living plague vaccine is put in such cases:
- when in natural foci of infection or in the forthcoming exit to a dysfunctional area;
- at work, associated with possible exposure to sources of infection;
- when there is a wide spread of infection among animals in the vicinity of settlements.
Plague - morbidity statistics
Thanks to the development of medicine and the maintenance of interstate preventive measures, the plague disease rarely runs widely. In ancient times, when no medicine was invented for this infection, mortality was almost one hundred percent. Now these figures do not exceed 5-10%. At the same time, how many people died from the plague in the world in recent times, can not but worry.
Plague in the history of mankind
The plague in the history of mankind left devastating traces. The most widespread are such epidemics:
- "Justinian Plague" (551-580 gg.), Which began in Egypt, from which more than 100 million people died;
- the epidemic of "black death" (XIV century) in Europe, brought down from East China, which claimed about 40 million lives;
- plague in Russia (1654-1655 gg.) - about 700 thousand deaths;
- plague in Marseilles (1720-1722) - 100 thousand people died;
- a pandemic of plague (the end of the XIX century) in Asia - more than 5 million people died.
Plague in our days
Bubonic plague nowadays occurs on all continents, except for Australia and Antarctica. In the period from 2010 to 2015, more than 3 thousand cases of the disease were diagnosed, with a lethal outcome was observed in 584 infected. Most cases are registered in Madagascar (more than 2 thousand). Foci of plague have been noted in countries such as Bolivia, the USA, Peru, Kyrgyzstan, Kazakhstan, Russia and others. Endemic to the plague regions of Russia are: Altai, Eastern Urals, Stavropol, Transbaikalia, the Caspian lowland.