Yersinia pestis is a bacterium that causes plague. It can be transmitted to humans via infected flea bites. Plague manifests as bubonic, septicemic, or pneumonic plague. Bubonic plague causes swollen lymph nodes, while pneumonic plague affects the lungs. Septicemic plague occurs when the bacteria enters the bloodstream. Diagnosis involves microscopy, culture, or antigen detection of samples from lymph nodes, blood, or sputum. Treatment involves antibiotics like streptomycin, gentamicin, or doxycycline. Close contacts may receive prophylactic antibiotics. The Charminar monument in Hyderabad, India was built in 1591 to celebrate the end of a deadly

2. ADULT INFECTIOUS DISEASES
PROJECT BY :-
G.AMITESHWAR REDDY

4. Plague is an infectious disease that is
caused by the bacteria Yersinia pestis.

5. YERSINIA PESTIS
(formerly Pasteurella pestis) is a Gram-
negative, rod-shaped coccobacillus,
a facultative anaerobic bacterium that can
infect humans and animals
Resistant to freezing temperature and drying,
killed by heat and sunlight

6. • Y. pestis was discovered in 1894 by Alexandre Yersin,
a Swiss/French physician and bacteriologist from
the Pasteur Institute, during an epidemic of the
plague in Hong Kong.

7. EPIDEMIOLOGY
Naturally Occurring
• Bubonic
• Isolated cases
• SW United States
• April-October and hunting season
• Preceding rodent die-off
Bioterrorism
• Pneumonic (highly infectious)
• Large clusters
• Metropolitan cities
• No seasonality
• Lack of rodent die off

9. PLAGUE
Characterized by fever, chills, headache, malaise,
prostration, & leukocytosis that manifests in one or more of
the following clinical forms:-
Regional lymphadenitis (bubonic plague)
Septicemia w/o evident bubo (septicemic plague)
Plague pneumonia
Pharyngitis & cervical lymphadenitis (pharyngeal plague)

10. When a flea bites a human and contaminates the
wound with regurgitated blood, the plague carrying
bacteria are passed into the tissue. Y.pestis can
reproduce inside cells, so even if phagocytosed, they
can still survive. Once in the body, the bacteria can
enter the lymphatic system, which drains interstitial
fluid. Plague bacteria secrete several toxins, one of
which is known to cause dangerous beta-adrenergic
blockade.

14. BUBONIC PLAGUE
• Incubation:- 2-8 days
• Sudden onset nonspecific symptoms:- fever, chills, malaise, muscle
aches, headache
• Regional lymphadenitis (buboes)
• Swollen, very painful lymph nodes
• Typically inguinal, femoral, axillary, or cervical
• Erythema overlying skin
• May have surrounding edema
• Concurrent with or shortly after onset of other symptoms

16. PNEUMONIC PLAGUE
• Incubation: 1-6 days (usually 2-4 days)
• Acute onset of fever with cough, dyspnea, and chest pain
• Hemoptysis characteristic; watery or purulent sputum also
possible
• Prominent GI symptoms may be present, including nausea,
vomiting, diarrhea, and abdominal pain

18. SEPTICEMIC PLAGUE
1. Lymphatics ultimately drain into the bloodstream, so the bacteria enter
the blood and travel to almost any part of the body.
2. In septicemic plague, bacterial endotoxins cause disseminated
intravascular coagulation (DIC), causing tiny clots throughout the body
and possibly ischemic necrosis from the clots.
3. DIC results in depletion of the body's clotting resources, so that it can no
longer control bleeding.
4. Consequently, there is bleeding into the skin and other organs, which
can cause red and/or black patchy rash and hemoptysis/hematemesis
(coughing up/ vomiting of blood).

20. PHARYNGEAL PLAGUE
This is an uncommon form of plague that
resembles tonsillitis found in cases of close
contact of patients with other forms of plague

23. LABORATORY DIAGNOSIS
• Direct examination:- sputum, blood, buboes aspirate
• Gram stain, Giemsa or Wayson stain :-
1. gram negative coccobacillus
2. Bipolar staining
• Cultures: positive within 24-48 hours

24. TREATMENT
• Aminoglycosides x 10days,
• Ciprofloxacin x 10days,
• Doxycycline x 10days,
• Chloramphenicol x 10days.

25. POST EXPOSURE TREATMENT &
PROPHYLAXIS
• The following patients require isolation and IV antibiotics :-
• All people with fever > 101
• All people with cough
• Infants with tachypnea
• Asymptomatic people within 2 meters of an untreated case
should take PO antibiotics
• Ciprofloxacin, Doxycycline for 7 days

26. VACCINATION
Vaccine is not currently available

27. INFECTION CONTROL
• Isolation of patient until 48h of adequate rx
• Droplet precautions :-
- Surgical mask, gown, gloves, eye shield
• Close contacts who refuse prophylaxis much be watched carefully
x 7 days
• Alert hospital personnel
• Limit aerosol-generating procedures

28. The Charminar is a monument and mosque in
Hyderabad, India. The structure was built in 1591
AD. It is the most famous building of Hyderabad
and also one of the most famous buildings in
India. It was built by Muhammad Quli Qutb Shahi
to celebrate the end of a deadly plague.

30. THIS COMPLETES THE CURRENT
PRESENTATION