17th June 2024

Plague

Plague, caused by the bacteria Yersinia pestis, is generally transmitted by fleas and can present in three forms. Bubonic and septicaemic plague is what is classically depicted in images from the 14th century pandemic. Bubonic plague is characterised by fever, malaise, and the appearance of buboes; painful, swollen lymph nodes. Septicaemic plague is characterised by shock and tissue necrosis – “black death”. Pneumonic plague, which can be transmitted from person to person via respiratory droplets or develop from untreated bubonic or septicaemic plague, is associated with a rapidly progressive multilobar consolidative process. Buboes can be sampled for diagnosis, or samples of sputum or blood can be analysed. A variety of classes of antibiotic are used as treatment. Post-exposure antibiotic prophylaxis is recommended after contact with pneumonic plague. A vaccine exists for individuals expected to be at high risk of the disease, such as exposed healthcare workers and clinical scientists.