Bubonic Plague (Black Death): What Is It, Symptoms, Treatment

Overview

What is the Bubonic Plague?

• An infectious disease caused by the bacterium Yersinia pestis, affecting humans and animals.
• Spread primarily by fleas traveling on rodents.
• Bubonic plague is named for swollen lymph nodes (buboes), which can become large and ooze pus.
• Other types of plague include:
  • Septicemic plague: Infection throughout the body.
  • Pneumonic plague: Infection in the lungs.

Historical Context

• Also known as the Black Death, killing over 25 million people in the 14th century Europe.
• Spread by rats on ships, leading to blackened gangrenous tissue, hence the name Black Death.

Current Occurrence

• Still occurs worldwide, including the U.S., with 7 cases per year on average.
• Mainly in Northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon, and western Nevada.

Symptoms and Causes

Symptoms

• Sudden high fever and chills.
• Abdominal, arm, and leg pain.
• Headaches.
• Large swollen lymph nodes (buboes) leaking pus.
• Septicemic plague may cause gangrenous blackened tissue and unusual bleeding.
• Pneumonic plague may cause difficulty in breathing and coughing up blood.

Causes

• Caused by the bacterium Yersinia pestis, spread by fleas.
• Zoonotic disease, spreading between animals and humans.
• Cats particularly vulnerable, spreading the infection to humans.
• Rare human-to-human transmission, mainly in pneumonic plague cases.

Diagnosis and Tests

Diagnosis

• Blood or tissue samples tested for presence of Yersinia pestis.

Management and Treatment

Treatment

• Treatable and curable with antibiotics:
  • Ciprofloxacin, levofloxacin, moxifloxacin.
  • Gentamicin.
  • Doxycycline.
• Hospitalization and possible isolation if diagnosed.

Consequences of Untreated Plague

• Can lead to fatal outcomes.
• Untreated, it may develop into septicemic or pneumonic plague.

Outlook / Prognosis

Prognosis

• Good if treated promptly (within 24 hours of symptom development).
• Recovery likely within one to two weeks.
• High fatality rate if untreated.

Prevention

Preventive Measures

• Make home and yard inhospitable to rodents and wild animals.
• Use flea control products for pets.
• Avoid letting pets who roam outside sleep in beds.
• Wear protective clothing when handling dead animals.
• Use insect repellent with DEET or permethrin in risky areas.

Living With

When to Contact Healthcare Provider

• Develop symptoms like high fever, pain, swollen lymph nodes.
• After exposure to flea bites or contact with infected individuals.

Additional Notes

• Bubonic plague still present, particularly in rural U.S. areas.
• Prevention focuses on avoiding fleas and protecting pets.