Pulmonary plague

When thinking of the plague, the image of the Middle Ages often immediately emerges. However, there are still minor outbreaks of the disease. The Pulmonary plague is the second form of plague alongside bubonic plague. While around 20 million people fell victim to the plague many years ago, today it is around 1,000 to 2,000 per year.

What is pneumonic plague?

The plague is a bacterial disease. This can be very different. In the Pulmonary plague however, the course is almost always acute. If left untreated, those affected have no chance of survival. There are different forms of plague, all of which are transmitted by the same pathogen. The plague is also called Black Death refers to the earlier epidemics, among other things.

The plague is actually a rodent disease. However, humans can either become infected through direct contact with infected animals or through exchange between humans and humans. Among the various forms of plague, pulmonary plague is the least common, but no less devastating.

The pathogen is transmitted through a droplet infection and thus comes into direct contact with the lungs. The immune system reacts too late and various complaints arise, such as bloody sputum. If left untreated, pneumonic plague is fatal for many of those affected. If the patient is already suffering from another form of plague, the pathogen can enter the lungs through the blood and trigger a secondary pulmonary plague.

causes

The pneumonic plague is caused by the bacterium Y. pestis. This has been known for 1000 years. In earlier times in particular, the plague cost many people their lives. The main reason was a lack of knowledge about adequate protection and treatment. Research has now shown that the bacterium is mainly found in rodents and is transmitted to humans by fleas.

Rats or poor hygiene standards in the household are considered risk factors. Infection through humans is also possible. Accordingly, caring for a sick person also poses a risk. In the western part of the country, the pulmonary plague seems to have already disappeared. However, there are still outbreaks.

These are usually regionally limited and can be localized, for example, in Madagascar, Congo, China, India, Peru and the southwest of the USA. In Germany, however, no case of the disease has been reported for decades.

Symptoms, ailments & signs

In pneumonic plague, the bacterium has entered the lungs. The first symptoms are usually noticeable after a few hours. First there is a fever and general weakness. Serious complaints such as abdominal pain and bloody sputum can appear on the second day.

The pulse rises and many people suffer from shortness of breath. Due to the strong urge to cough, vomiting is also possible. Patients complain of chills, headache, blue lips and fatigue. Coughing up the mucus is felt to be very painful. In the further course, pulmonary edema can develop.

Overall, circulatory failure cannot be ruled out. The pathogen can be detected in both sputum and saliva. Pneumonia sufferers therefore pose a serious risk of infection for healthy people. The bacterium can be transmitted, for example, via a droplet infection that is triggered by a sneeze.

Diagnosis & course of disease

The symptoms are not always immediately assigned to pneumonic plague. Instead, the disease can be misdiagnosed as pneumonia, for example. Proof of the bacterium is necessary for clear verification. For this, samples of the mucus or blood are taken and examined accordingly in the laboratory.

If the pneumonic plague is not recognized and treated early, the probability of death is very high. Around 95 percent of those affected do not survive the disease in this case. Appropriate treatment reduces the risk to 15 percent.

Complications

Pneumonic plague is a very serious disease that can usually be fatal if left untreated. Although it doesn't happen very often, it definitely needs to be examined and treated by a doctor. Those affected primarily suffer from fever and abdominal pain. There is general weakness in the patient and those affected suffer from exhaustion.

Shortness of breath continues to occur, so that the body is insufficiently supplied with oxygen. Those affected suffer from headaches and blue lips. Furthermore, it can also lead to a loss of consciousness. If the pneumonic plague is not treated, circulatory failure can occur and lead to death of the person concerned.

However, complications usually only occur if the disease is not treated or misdiagnosed as pneumonia. Pulmonary plague is also highly contagious, so those affected have to avoid contact with other people. Treatment of pneumonic plague can be carried out with the help of antibiotics and, as a rule, leads to a positive course of the disease. There are usually no complications. With successful and, above all, early treatment, the life expectancy of the person affected is not reduced or restricted.

When should you go to the doctor?

If symptoms such as shortness of breath or cough suddenly become noticeable, a doctor must be consulted. It may be caused by pneumonic plague that needs to be examined and treated if necessary. If there are any external signs such as the characteristic blue coloration of the lips, an immediate doctor's visit is necessary. Medical advice is needed at the latest when cardiovascular problems, headaches or fatigue occur. Other warning signs that need to be investigated include bloody sputum, severe pain, and a throbbing sensation in the lungs.

Pneumonic plague progresses very quickly and leads to serious complications such as blood poisoning and organ failure. A quick clarification is therefore essential, especially if there is a concrete suspicion. A doctor must be consulted if the symptoms mentioned occur in connection with a flea or rat bite or a trip to Asian countries. People who suffer from bubonic plague or who have someone in their immediate vicinity are also at risk and should seek medical advice quickly. Pneumonia must be treated by a general practitioner or a pulmonologist.

Treatment & Therapy

As soon as the pathogen has been detected, the patient is isolated to protect healthy people from infection. The room may only be entered on the basis of specific security regulations. Unnecessary contact is not permitted. Antibiotics can be used to treat pneumonic plague. For this purpose, agents such as streptomycin, gentamycin and tetracyclines such as doxycycline or chloramphenicol are used.

To avoid complications that negatively affect the course of the disease, treatment must begin as early as possible. A quick diagnosis can save the patient's life. During the last outbreak of the plague in Madagascar, experts were able to determine that the pathogen responsible no longer responded to the antibiotics used. The bacterium has thus become resistant.

Therefore, it may be necessary to use another antibiotic preparation. Even after starting therapy, patients remain contagious. People who have pneumonia will continue to be isolated for at least four days after taking the antibiotic for the first time. Only then can the quarantine be lifted. After surviving an infection, those affected have a certain immunity. A renewed infection is still possible.

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Outlook & forecast

The prognosis for pneumonic plague has improved significantly compared to the last millennium. If left untreated, it inevitably leads to the premature death of the patient. At an advanced stage of the disease, there is also little prospect of recovery. Pathogens spread too much within a short period of time and lead to the failure of the human organism to function properly. A good prognosis, on the other hand, is given to people who have a healthy and stable immune system, who have no previous illnesses and who consult a doctor in the early stages of pneumonic plague.

The highly contagious disease is treated immediately with medication. In addition, it is necessary to isolate the patient so that no other people can be infected by the pathogens. The progression of the disease is characterized by a rapid increase in symptoms and a rapid spread of physical irregularities. The intensity of the physical impairment increases within a few hours. So that there is a chance of survival, the person affected must be monitored and cared for by intensive medical care immediately. Otherwise there is little prospect of an improvement in the situation.

If complications or intolerance to the administered medication arise, the chances of recovery deteriorate further. Although there are various alternative preparations available thanks to medical advances, quick action is imperative for recovery.

prevention

The pneumonia can be prevented to a limited extent. Specific safety measures apply, especially in regions where the pathogen appears. It is best for travelers to avoid contact with rodents altogether. Care should be taken, especially with sick and dead animals. Mosquito sprays containing DEET prevent fleas from infecting people.

All pets should not be forgotten: they should be freed from fleas on a regular basis. In addition, unnecessary contact with the sick should be avoided. The same applies to clothing that has been around victims and rodents.

Aftercare

Because pneumonic plague is a very serious disease, follow-up care focuses primarily on maintaining the quality of life of those affected at an appropriate level. Pneumonic plague is rare but can be completely cured, so it is important to take follow-up care seriously. Those affected should take care of themselves and only carefully return to the usual rhythm.

As long as the acute phase is over, those affected are dependent on help in order to cope with their everyday lives despite persistent exhaustion and general weakness. Because pneumonic plague is highly contagious, those affected must avoid contact with the outside world and family members. This significantly reduces the quality of life. Antibiotics are usually prescribed for treatment. Normally the disease can be cured successfully with it. There are no complications. With timely treatment, the life expectancy of those affected will not be shortened.

You can do that yourself

Pneumonic plague is an extremely rare but very dangerous and above all highly contagious infectious disease in western countries. The pneumonic plague must be treated by a doctor as soon as possible, otherwise the risk of morbidity is over 90 percent. Self-help measures are only indicated insofar as the patient can help ensure that the disease is correctly diagnosed and the risk to third parties is kept as low as possible.

In the early stages, pneumonia resembles pneumonia and is very often misdiagnosed due to its rare occurrence, which can be life-threatening for the patient. Anyone who has traveled to a risk area shortly before the outbreak of the disease and shows symptoms that are typical for pneumonic plague, must explicitly point this out to their doctor. The risk areas mainly include developing and emerging countries such as the Republic of the Congo, Madagascar, the Chinese hinterland, parts of India and Peru. Occasionally, pulmonary plague is also observed in the southwestern states of America.

Since the disease can be transmitted through droplets and the pathogen is extremely aggressive, the patient must be isolated immediately. For these reasons, home care should not be used. All medical Karantän regulations must be strictly observed. This also applies when children are affected. Parents are doing their offspring no favors if they endanger themselves through excessive care or even infect other family members.