Plague

Question 1

What Is the organism causing the plague?

Answer 1

Yersinia pestis - pseudo tuberculosis pestis
Gram -ve bacillus - stains like a closed safety pin

Question 2

Animal reservoirs for plague?

Answer 2

Urban and sylvatic rats
Fleas from rats regurgitate infectious remnants of pathogen into skin

Question 3

How else apart from fleas can plague be transmitted?

Answer 3

Person to person - air borne - pneumonic plague

Question 4

Pathogenesis of the disease?

Answer 4

Skin -> lymph nodes -> lymphatic obstruction and lymphedema
Thrombosis of blood vessels - haemorrhagic necrosis
Haematogenous spread to Liver, spleen, kidneys, lungs, meninges.

Question 5

Clinical manifestations of bubonic plague?

Answer 5

Chills, weakness, headache
Bubo in groin, axilla, neck, intensely painful , erythematous and warm.
Skin lesions may be vesicular/purpuric/necrotic/gangrenous
Progresses to multi organ failure. Liver, thrombocytopenia, sepsis and hypotension

Question 6

What is septicaemia plague?

Answer 6

Bacteramie without bulbo
Endotoxin causes CNS effects and high fatality rate

Question 7

What is pneumonic plague?

Answer 7

Plague in lungs mostly secondary - haematogenous spread.
Primary - inhalation, rapid onset (2-3 hrs)
Rapidly progressing respiratory failure

Question 8

Diagnosis of plague?

Answer 8

Culture using Wright -Gimsea or immunofluorescence
Other: haemoagglutination
Serology antibody testing

Question 9

What is the treatment of plague?

Answer 9

Ciprofloxacin, streptomycin, doxycycline, gentamicin for 14 days (same if contact),ISOLATION