Foci of plague exist on all continents, with the exception of Australia. In North America, plague is found in animals and their associated fleas from the Pacific Coast to the Great Plains, and from southwestern Canada to Mexico. Human cases have developed in New Mexico, Arizona, Colorado, Nevada, and California.

The case fatality rate for untreated bubonic plague in humans is about 50%. Untreated primary septicemic plague and pneumonic plague are invariably fatal. Modern therapy has markedly reduced fatalities from bubonic plague. Pneumonic and septicemic plague also respond if recognized and treated early.

Y. pestis may be identified microscopically by examination of Gram, Wright, Giemsa, or Wayson's stained smears of peripheral blood, sputum, and bubo or cerebrospinal fluids. Finding bipolar-staining, ovoid, Gram-negative organisms permits a rapid presumptive diagnosis of plague. Organisms may also be identified through bacteriologic culture.

Historically, the treatment of choice for bubonic, septicemic, and pneumonic plague has been streptomycin; however, this drug is no longer readily available. Alternatives include gentamicin, doxycycline, ciprofloxacin, and chloramphenicol.

Prevention of plague is based on control of rodents and vectors. Insecticides should be used to control insect populations, and these should be applied prior to or simultaneously with methods to eradicate rodent reservoir populations. Preventing contact between domestic hosts and wild rodent sources of infection is also important. Cats and dogs should be kept indoors and food and shelter should be denied to rats or wild rodents around residences and recreational areas.

The disease is transmitted from rats to man by small insects, (about 2-4 mm) i.e. rat-fleas which act as vector, i.e. they only transmit the disease, but do not suffer from it. Rather, they derive their blood meals from the plague-infected rats till the rats die. While sucking blood from... Vaccination is the key for the prevention of this disease. Therefore, a strict vaccination schedule must be followed.

Humans may develop bubonic, primary septicemic, or pneumonic plague from the bite of infected fleas; by handling tissues of infected animals, especially rodents and rabbits; by contact with airborne droplets from human patients or household pets (especially cats) with plague pharyngitis or pneumonia; or through careless manipulation of laboratory cultures.

Get immediate medical attention: To prevent illness, a person who has been exposed to pneumonic plague must receive antibiotic treatment without delay. If an exposed person becomes ill, antibiotics must be administered within 24 hours of their first symptoms to reduce the risk of death. Notify authorities: Immediately notify local or state health departments so they can begin to investigate and control the problem right away.

DO NOT TRADE because the caravans transfer the plague from town to town, so only use trade caravans to transfer goods and money between your own towns that are free of the plague. In addition to not sending out trade caravans, you must delete all items offered for sale in the trade screen of each town. You must not offer items for sale or other clan's caravans will come to your towns to buy those items, bringing the plague to you.

Remove all rodent harborage such as wood piles. Reduce or eliminate any outside food source such as bird-feeders or pet dishes. Do not allow pets to roam; restrain them to residence. Treat pets regularly for fleas. Seek medical/veterinary attention immediately if symptoms appear such as swollen lymph nodes, fever, fatigue, and loss of appetite.

Clinical signs in humans usually develop within 2 to 8 days of infection and include sudden onset of headache, fever, chills, and weakness. An acutely swollen and painful lymph node (bubo) often appears approximately 24 hours after the start of clinical signs. Some individuals may develop septicemia without a bubo (primary septicemic plague) or septicemia may occur secondary to bubonic plague.

Plague resulting from aerosolization of Y. pestis is of most concern when considering the use of plague as a biological weapon. This information has been prepared as a service by the American Veterinary Medical Association. Redistribution is acceptable, but the document's original content and format must be maintained, and its source must be prominently identified.

No one knows - when people lived in crowded conditions before soap or antibiotics, many infectious diseases were fatal. The usual assumption - that Eyam was ravaged by bubonic plague - rests upon shaky evidence. Diseases such as measles or flu have been equally deadly when introduced to isolated communities in recent times. However, a Channel 4 program shown in Feb.

Plague exists in nature as a disease of wild rodents, including rats, ground squirrels, and prairie dogs. Plague is transmitted primarily by fleas as part of an etiologic agent (Y. pestis)-arthropod vector-vertebrate host cycle. Carnivores (e.g., dogs, coyotes, raccoons, and skunks) may become infected, but with the exception of cats, they rarely develop clinical signs. Infection of carnivores is most likely due to ingestion of plague-infected animals rather than fleabites.