Early antibiotic therapy is recommended for persons deemed exposed to or infected with plague. Tetracyclines eg, doxycycline , fluoroquinolones eg, ciprofloxacin , and aminoglycosides eg, streptomycin, although not widely available, and gentamicin are all antibiotics that have been used for post-exposure prophylaxis and treatment of plague.
Specific treatment recommendations following a biological attack with plague will depend on several factors, including antibiotic susceptibility of the strain. Antibiotic treatment should be initiated within 24 hours for patients showing symptoms of pneumonic infection, and should be continued for 10 days. Prophylactic antibiotics may be administered to protect people who have had known direct contact with infected patients, and should be continued for 7 days.
People with suspected exposure to pneumonic plague should be placed under surveillance and monitored for symptoms. If symptoms develop, antibiotic therapy should be initiated immediately and continued for 10 days.
In addition to antibiotic prophylaxis, people with established ongoing exposure to a patient with pneumonic plague should use standard respiratory droplet precautions. A vaccine for plague is not currently available for civilian use in the United States. This vaccine has some efficacy in preventing or lessening the severity of bubonic disease in a pre-exposure setting; however, it has not been shown to be effective in preventing pneumonic plague.
Research and development efforts for both an attenuated live vaccine and a subunit vaccine that protects against pneumonic plague are ongoing. Additionally, a number of promising new antibiotics and intervention strategies have yet to be fully explored experimentally.
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Find an article or report by keywords: Enter Search Phrase. Find an article or report or see all by area, author, or year:. Year Background Plague is an infectious disease caused by Yersinia pestis , a naturally occurring bacterium found primarily in wild rodents.
Three forms of naturally occurring plague infection exist: Pneumonic plague is the result of Y. Primary pneumonic plague results from inhalation of Y. Take the following precautions if you live or spend time in areas where plague outbreaks occur:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Plague is a serious bacterial infection that's transmitted primarily by fleas.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references AskMayoExpert. Rochester, Minn. Sexton DJ, et al. Clinical manifestations, diagnosis, and treatment of plague Yersinia pestis infection.
Plague and other Yersinia infections. Merck Manual Professional Version. Signs and symptoms can begin within a few hours after infection, and may include:. Pneumonic plague progresses rapidly and may cause respiratory failure and shock within two days of infection. Pneumonic plague needs to be treated with antibiotics within a day after signs and symptoms first appear, or the infection is likely to be fatal. If you begin to feel ill and have been in an area where plague has been known to occur, seek immediate medical attention.
You'll need treatment with medication to prevent serious complications or death. In the United States, plague has been transmitted to humans in several western and southwestern states — primarily New Mexico, Arizona, California and Colorado. Worldwide, plague is most common in rural and semirural parts of Africa especially the African island of Madagascar , South America and Asia.
The plague bacteria, Yersinia pestis, is transmitted to humans through the bites of fleas that have previously fed on infected animals, such as:. The bacteria can also enter your body if a break in your skin comes into contact with an infected animal's blood. Domestic cats and dogs can become infected with plague from flea bites or from eating infected rodents. Pneumonic plague, which affects the lungs, is spread by inhaling infectious droplets coughed into the air by a sick animal or person.
The risk of developing plague is very low. Worldwide, only a few thousand people develop plague each year. However, your plague risk can be increased depending on the area where you live and travel, your job, and your hobbies. Plague outbreaks are most common in rural and semirural areas that are overcrowded, have poor sanitation and have a high rodent population. The greatest number of human plague infections occur in Africa, especially the African island of Madagascar.
Plague has also been transmitted to humans in parts of Asia and South America. In the United States, plague is rare, but it has been known to occur in several western and southwestern states — primarily New Mexico, Arizona, California and Colorado.
Veterinarians and their assistants have a higher risk of coming into contact with domestic cats and dogs that may have become infected with plague. People who work outdoors in areas where plague-infected animals are common are also at higher risk of getting plague. Camping, hunting or hiking in areas where plague-infected animals reside can increase your risk of being bitten by an infected flea.
No effective vaccine is available, but scientists are working to develop one. Antibiotics can help prevent infection if you're at risk of or have been exposed to plague. Take the following precautions if you live or spend time in areas where plague outbreaks occur:.
If your doctor suspects plague, he or she may look for the Yersinia pestis bacteria in samples taken from your:. As soon as your doctor suspects that you have plague, you'll need to be admitted to a hospital. You'll receive powerful antibiotics, such as:. Fleas become infected by feeding on rodents, such as chipmunks, prairie dogs, ground squirrels, mice, and other mammals that are infected with the bacterium Yersinia pestis.
Fleas transmit the plague bacteria to humans and other mammals during a subsequent feeding. The plague bacteria survive briefly a few days in the blood of rodents and for longer periods in the fleas. An illustration of plague ecology in the United States is available. Yes, when a person has plague pneumonia they may cough droplets containing the plague bacteria into air. If these bacteria-containing droplets are breathed in by another person they can cause pneumonic plague.
Human-to-human transmission is rare and typically requires direct and close contact with the person with pneumonic plague. A person usually becomes ill with bubonic plague 2 to 6 days after being infected. Someone exposed to Yersinia pestis through the air would become ill within 1 to 3 days.
When bubonic plague is left untreated, plague bacteria can invade the bloodstream. When plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition called septicemic plague. Untreated bubonic plague can also progress into an infection of the lungs, causing pneumonic plague. If plague patients are not given specific antibiotic therapy, all forms of plague can progress rapidly to death.
The first step in plague diagnosis is evaluation by a health worker. Once the laboratory receives the sample, preliminary results can be ready in less than two hours. Laboratory confirmation will take longer, usually 24 to 48 hours. Often, presumptive treatment with antibiotics will start as soon as samples are taken, if plague is suspected.
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