what causes pneumonic plague
Pneumonic plague is the most dangerous type of plague caused by Yersinia pestis (Y pestis) and occurs when the bacterium infects the lungs

Pneumonic plague is the most dangerous type of plague caused by Yersinia pestis (Y pestis) and occurs when the bacterium infects the lungs. The disease can spread through the air from person to person.

Anyone infected with pneumonic plague has the potential to spread the disease to others via droplets. The time between exposure to the bacteria and the onset of infection (incubation period) may be as little as 24 hours. 

If not recognized and treated early, pneumonic plague can be lethal if left untreated. However, if found and treated early enough, recovery rates are good (within 24 hours of the onset of symptoms).

What are the signs and symptoms of pneumonic plague?

Signs and symptoms of pneumonic plague emerge 1-4 days after exposure to the bacteria and may include:

Respiratory failure and shock are possible complications of pneumonia. Because pneumonia rapidly progresses, it can be fatal if not treated properly.

What are the different types of plague?

The plague can manifest itself in three ways:

  1. Pneumonic plague (lung infection): When an infected individual coughs or sneezes, someone who inhales the droplets can develop the infection. Pneumonic plague may be purposely transmitted (as a bioweapon) if the bacterium was put into aerosol form.
  2. Bubonic plague (lymph node infection): The most prevalent form of plague is bubonic plague, which can proceed to septicemic plague if left untreated. Y pestis enters the body through a bite from an infected flea or a cut or break in the skin. Swollen, painful lymph nodes are referred to as "buboes." 
  3. Septicemic plague (blood infection): Septic shock occurs when Y pestis bacterium multiplies in the bloodstream. Symptoms may include bleeding under the skin, bleeding from the nose mouth or anus, dark or black skin especially of the toes, feet, fingers, and nose, abdominal pain, nausea, vomiting, diarrhea, and finally shock.

Have there been modern outbreaks of the plague?

The plague does still exist, but it is extremely rare. There have been sporadic cases of the plague reported in the United States and other countries over the past couple of years. Two persons were diagnosed with plague in China in November 2019. 

In China, officials discovered a new instance of bubonic plague in July 2021 during the COVID-19 pandemic, which was believed to be contracted from animals. Hence, local health officials recommended residents to avoid shooting, eating, or transporting animals that could carry the disease.

According to news sources, a woman in Wyoming has been diagnosed with pneumonic plague in September 2021, which she contracted through one of her pet cats. The plague may come as a scare to people because it is the disease that sparked the “Black Death” pandemic in the mid-1300s.

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Will there be another plague pandemic?

People are worried there could be another plague pandemic amid the COVID-19 pandemic. Though there have been a few cases reported every year, it is unlikely that there is the danger of another pandemic because of the plague, especially the bubonic plague. Human-to-human transmission of pneumonic plague can occur, but it is extremely rare.

Unlike COVID-19, the bubonic plague has a definite therapy that doctors are aware of. Furthermore, the disease is uncommon. Health officials are aware of how the disease spreads and manifests and how to prevent it. One way to prevent it is by not handling ill or dead animals in situations where transmission is possible.

How is the plague treated?

Antibiotics are available to treat infected patients. Antibiotics may also be prescribed for people who may have been exposed to germs to prevent them from getting ill. 

Because the plague is a deadly disease, it is important to consult a doctor right away to receive prompt treatment and avoid complications. With treatment, symptoms may improve within 1-2 weeks. However, without treatment, complications can occur, including death.

How can the plague be prevented?

Currently, there is no vaccine for the plague. So, the best way to prevent plague is by taking the following measures:

  • Avoiding areas with the plague if possible
  • Staying away from ill or dead animals
  • Staying away from people who have symptoms and encouraging them to seek treatment right away

If you live in an area where one or more cases of the plague have been reported, the following measures can help reduce the risk of contracting the infection:

  • Filling cracks and gaps at home to keep away mice, rats, and squirrels
  • Taking care of your lawn and removing any mounds of leaves, dead wood, or pebbles that could serve as a habitat for animals
  • When hiking or camping, using insect repellents to avoid flea bites
  • Wearing gloves and masks when handling sick or dead animals or live wild animals
  • Treating pets with flea control sprays or other treatments
  • Avoiding allowing outdoor pets, such as cats or dogs, to sleep in your bed or couch
  • Maintaining proper hygiene
  • Covering open wounds

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Medically Reviewed on 10/5/2021
References
World Health Organization. Plague. https://www.who.int/news-room/fact-sheets/detail/plague

Minnaganti VR. Plague. Medscape. https://emedicine.medscape.com/article/235627-overview

Frith J. The History of Plague – Part 1. The Three Great Pandemics. J Mil Veterans' Health. 20(2). https://jmvh.org/article/the-history-of-plague-part-1-the-three-great-pandemics/

Wyoming Department of Health. Wyoming Detects Rare Human Case of Pneumonic Plague. https://health.wyo.gov/wyoming-detects-rare-human-case-of-pneumonic-plague/

BBC News. China Bubonic Plague: WHO 'Monitoring' Case but Says It Is 'Not High Risk.' https://www.bbc.com/news/world-asia-china-53325988