Plague

Plague is a quarantine natural focal disease characterized by high fever, severe intoxication, the presence of buboes (hemorrhagic-necrotic changes in the lymph nodes, lungs and other organs), as well as sepsis. The causative agent is a motionless, barrel-shaped plague bacillus.

Refers to especially dangerous infections. In nature, it is preserved due to periodically occurring epizootics in rodents, the main warm-blooded hosts of the plague microbe (marmots, ground squirrels, gerbils). The transmission of the pathogen from animal to animal occurs through fleas. Infection of a person is likely by contact (when skinning and butchering meat), eating contaminated food, flea bites, and airborne droplets. Human sensitivity is very high. A sick person is dangerous to others, especially those with a pulmonary form.

Symptoms and course of the plague. The incubation period of the plague lasts 3-6 days. The disease begins acutely with a sudden onset of chills and a rapid rise in temperature to 40C. Chills are replaced by fever, severe headache, dizziness, severe weakness, insomnia, nausea, vomiting, muscle pain. Intoxication is expressed, disturbances of consciousness are frequent, psychomotor agitation, delirium, hallucinations are not uncommon. Unsteady gait, redness of the face and conjunctiva, slurred speech are characteristic (patients resemble drunkards). Facial features are pointed, puffy, dark circles under the eyes, a suffering expression full of fear are found. The skin is dry and hot to the touch, a petechial rash is possible, extensive hemorrhages (hemorrhages) that darken on corpses. Symptoms of damage to the cardiovascular system develop rapidly: expansion of the boundaries of the heart, deafness of tones, increasing tachycardia, drop in blood pressure, arrhythmia, shortness of breath, cyanosis. The appearance of the tongue is characteristic: thickened, with cracks, crusts, covered with a thick white coating. The mucous membranes of the mouth are dry. The tonsils are often enlarged, ulcerated, with hemorrhages in the soft palate. In severe cases, vomiting of the color of “coffee grounds”, frequent loose stools with an admixture of mucus, blood. In the urine, an admixture of blood and the presence of protein is possible.

There are two main clinical forms of plague: bubonic and pneumonic.

With bubonic plague , a sharp pain appears in the area of ​​\u200b\u200bthe affected lymph glands (usually inguinal) even before their noticeable increase, and in babies, axillary and cervical. Regional lymph glands are affected at the site of a flea bite. They quickly develop hemorrhagic necrotic inflammation. The glands are soldered together, with adjacent skin and subcutaneous tissue, forming large packages (buboes). The skin becomes glossy, reddens, subsequently ulcerates, and the bubo opens outward. In the hemorrhagic exudate, the glands are found in a large number of plague sticks.

In the pulmonary form (primary) of plague , hemorrhagic inflammation appears with necrosis of small pulmonary foci. Then there are cutting pains in the chest, palpitations, tachycardia, shortness of breath, delirium, fear of a deep breath. Cough appears early, with a large amount of viscous transparent, glassy sputum, which then becomes frothy, thin, rusty. The pain in the chest intensifies, breathing sharply weakens. Typical symptoms of general intoxication, rapid deterioration, development of infectious toxic shock.

The prognosis is difficult, death begins, as a rule, on the 3rd-5th day.

Plague recognition. Based on clinical and epidemiological data, the final diagnosis is based on laboratory tests (bacterioscopic, bacteriological, biological, serological).

Plague treatment. All patients are subject to hospitalization. The main principles of therapy are the complex use of antibacterial, pathogenetic and symptomatic therapy. The introduction of desitoxication liquids (polyglucin, reopoliglyukin, hemodez, neokimpensan, plasma, glucose solution, saline solutions, etc.) is shown.

Plague Prevention . Control of rodents, especially rats. Observation of persons working with infectious materials or suspected of being infected with plague, prevention of the importation of plague into the country from abroad.