The document discusses plague, caused by the bacterium Yersinia pestis. It summarizes the history and epidemiology of plague epidemics, describes the different forms of plague (bubonic, septicemic, pneumonic), transmission cycles, signs and symptoms, diagnosis, treatment and prevention. Despite availability of treatments, mortality from plague remains high. The highest number of plague cases are now reported in some African countries rather than Asia.

1. SUBMITTED TO:
Dr. Kakoli Dutt
Dept. of Bioscience &
Biotechnology
SUBMITTED BY:
Anveshika Manoj
B.Tech(III) Year
7282

2.  1st epidemic (Antiqua) –
541 AD; Mediterranean region,
50-60% of pop.
 2nd epidemic (Medievalis) –
1346-1351; 1/3 of the pop. of
Europe died (20-30 million)
 3rd epidemic (Orientalis) –
1855-1890; started in China,
spread through Asia; 10 million
died in India alone JUSTINIAN
THE ROMAN EMPEROR

3. Bubonic
Septicemic
• Primary
• Secondary
Pneumonic
• Primary
• Secondary

4.  Most common form
(~85% of all cases).
 Causes swollen lymph
nodes (buboes).
 Spread via direct contact
with bubo drainage.
 The backbone of the
survival of Y. pestis .

5.  Causes severe blood
infection throughout the
body and gangrene of acral
regions
Primary:
• occurs when a flea
inserts y. pestis directly
into the bloodstream
Secondary:
• occurs as a severe
development from
bubonic or pneumonic

6. • Least common, yet most
dangerous form.
• Transmitted via direct
inhalation of the germs.
Primary:
• occurs via inhalation
of pneumonic
respiratory droplets
Secondary:
• occurs when bubonic
or septicemia plagues
spread to the lungs

7. Fleas live in nests of wild rodents.
Disturbance (war, flood etc) cause
wild rodents to migrate to urban
areas.
Infected fleas jump from wild
rodents to domesticated rodents,
pets .
 Direct infection from animals
possible.
Human-to-human transmission via
respiratory droplet (pneumonic
plague).

8.  For Bubonic :>
 Pain/tenderness at regional
lymph nodes enlarge to
become “buboes
 Ulcer or skin lesions at site
of flea bite in <10% of cases
For Septimic :>
• 1º SEPTICEMIC PLAGUE is
due to spreading of Y. pestis
by way of the bloodstream
from the site of inoculation
without bubo formation

9. For Septimic :>
• Hemorrhagic changes in skin
called “purpuric lesions”
• Extremity gangrene
 For Pneumonic:>
• Productive cough
• Hemoptysis
• Rapid, shallow breathing
• Cyanosis
• Nausea and vomiting
• Abdominal pain

10. Conditions for -
 Suspected Plague:
 Clinical symptom of plague
 Recently traveled to a plague-endemic region
 Presumptive Plague :
• Immunofluorescence stain of sample is positive for the
presence of Y. pestis F1 antigen
 Confirmed Plague:
• Isolate Y. pestis from the specimen
• Observe at least a 4 fold elevation in serum antibody titer
to the F1 antigen

11. ADULT
CHILDREN
PREGNANT
WOMAN

12. ADULT
CHILDREN
PREGNANT
WOMAN

13. • Isolate infected animals
• Flea and Rodent control
• Prevent roaming or
hunting of pets
• Insect repellents for skin
& clothes
• Insecticide use in
epizootic areas
• Call for more inquiry at
CDC at (800)232-4636.

14. 1. Although there has been a general decline in the
incidence of plague worldwide, the number of
countries affected by plague remains substantial.
2. There has been an obvious change in the
distribution of plague morbidity by continent.
Whereas in the 1970s plague cases were reported
predominately from Asia, in the 1980s and the 1990s a
small number of African countries with well-known
natural plague foci reported the highest number
of cases.
3. Despite the availability of a number of highly
effective therapeutic agents, mortality due to plague
remains unacceptably high

15. www.bt.cdc.gov/agent/plague/index.asp
www.cdc.gov/ncidod/dvbid/index.htm
www.medicinenet.com
www.who.int/csr/resource/publications/survil
lance/en/plague/pdf
www.mass.gov/eohhs/docs/dph/cdc/factsheet/
plague.pdf
www.ct.gov/dph/lib/dph/php/bt/pdf/plague.p
df