What are the other Names for this Condition? (Also known as/Synonyms)

• Plague causing Lung Infection

What is Pneumonic Plague? (Definition/Background Information)

• Plague is an infectious disease caused by the bacterium Yersinia pestis. Humans are typically infected through rodent or flea bites, or from close contact with the infected animal
• There are 3 main types of Plague, namely:
  • Bubonic Plague, when the bacteria infect the lymph nodes
  • Septicemic Plague, when the bacteria infect and multiply in blood
  • Pneumonic Plague, when the bacteria infect the lungs and cause pneumonia
• Pneumonic Plague is a deadly disease that is transmitted by inhaling respiratory droplets containing the bacteria (such as during coughing or sneezing) when in close contact with an infected human being or an infected animal (rodent)
• There is a higher risk for infection in the tropical and sub-tropical regions. The risks also include certain occupations (such as farming), being a vet, coming in close contact with infected animals, hunting, and outdoor camping
• Pneumonic Plague signs and symptoms can develop within 3 days of infection. It is mostly characterized by shortness of breath, bloody sputum, and chest pain
• The healthcare provider arrives at a diagnosis of Pneumonic Plague from assessing the symptoms, studying the affected individual’s work and travel history, and through blood and sputum tests to check for the causative organism
• If the underlying infection and associated signs and symptoms are treated in a timely manner, Pneumonic Plague is a curable condition. The treatment usually involves the prompt administration of antibiotics. Individuals with Pneumonic Plague should be isolated in a hospital setting and in some cases, respiratory support have to be provided
• The prognosis generally depends upon the severity of the underlying signs and symptoms due to the bacterial infection. With prompt diagnosis and treatment of Pneumonic Plague, a full recovery can be ensured. However, delayed treatment or an absence of treatment is typically fatal
• Avoiding contact with infected individuals or animals, maintaining personal hygiene, keeping the immediate home and work environment free of rodents (such as by getting rid of potential or existing rodent habitat), and taking precautions while handling animals can help prevent Pneumonic Plague

Who gets Pneumonic Plague? (Age and Sex Distribution)

• Pneumonic Plague is a bacterial infection that can affect individuals of all age groups
• There is no gender preference and both males and females are affected
• Generally, the infection is observed worldwide and all racial and ethnic groups are at risk
• However, the disease spreads rapidly in tropical and sub-tropical places, wherever rodent (rat) population is high

What are the Risk Factors for Pneumonic Plague? (Predisposing Factors)

The following risk factors for Pneumonic Plague infection are noted:

• Being around an individual with Pneumonic Plague is a major risk factor
• Location: Individuals who live in areas where rat population is more and overcrowding is common have a high risk of contracting infection due to Yersinia pestis
• Occupation: Individuals, whose occupation necessitates close contact with animals (rodents), such as veterinarians, farmers, and hunters, have a very high risk
• Hobbies: Individuals with hobbies, such as camping, hunting, or hiking, are vulnerable to the disease in Plague-affected areas

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pneumonic Plague? (Etiology)

Pneumonic Plague is caused by a bacterial infection. The bacterium Yersinia pestis infects rodents and fleas, which in turn, infects humans. The transmission can occur in the following manner:

• Primary transmission: Infection from being in close contact with an individual infected with Pneumonic Plague through inhalation of infected respiratory droplets (produced while coughing, sneezing, or even talking)
• Secondary transmission: Infection that develops as a result of untreated Bubonic or Septicemic Plague spreading to the lungs

What are the Signs and Symptoms of Pneumonic Plague?

The signs and symptoms of Pneumonic Plague usually appear within 3 days of infection. The signs and symptoms may include:

• Fever and chills, fatigue
• Shortness of breath
• Nausea
• Cough with bloody sputum
• Chest pain

How is Pneumonic Plague Diagnosed?

The diagnosis of Pneumonic Plague may involve the following tests and exams:

• Physical examination and examining the signs and symptoms of the affected individual
• Medical history evaluation, including recent travel history
• Recent history of rodent bites (such as from rats or rabbits)
• Blood and/or sputum tests (mucus from saliva and respiratory tract) to check for the presence of the causative bacterium

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pneumonic Plague?

Pneumonic Plague, if left untreated, can lead to certain serious complications such as:

• Gangrene: Blood clots appear in the blood vessels affecting the free flow of blood to the fingers and toes. This may necessitate amputation of the fingers and toes
• Meningitis: An inflammation of the membranes surrounding the brain and spinal cord
• Pneumonia (infection of lung)
• Respiratory failure leading to death, in case of untreated infection

Pneumonic Plague is a highly contagious and dangerous infection that can spread from one individual to another resulting in a deadly epidemic.

How is Pneumonic Plague Treated?

Any individual who tests positive for Pneumonic Plague should be given immediate medical attention. The treatment may involve the following measures:

• A dose of powerful antibiotics, such as streptomycin, gentamicin, doxycycline, ciprofloxacin, or chloramphenicol, either individually or in combination, is normally administered
• In some cases, intravenous fluids, oxygen and respiratory support may also be required
• All individuals with Pneumonic Plague should be kept isolated from others

How can Pneumonic Plague be Prevented?

An immediate isolation and treatment of all individual with Pneumonic Plague can prevent its rapid spread. However, the following factors may be considered in preventing Plague:

• Cleanliness and personal hygiene
• All necessary steps must be taken to ensure that one’s surroundings are free of rodents
• Keeping the residential environment clean is an important preventive method
• Places that can potentially harbor and colonize rodents (especially rats) should be eliminated or sanitized to prevent infestation
• Dead animals and rodents have to be handled extremely carefully and to strict safety standards; ensure that open skin wounds, if any, are kept properly covered and protected
• Follow government advisories on disease outbreaks and schedule travel plans accordingly
• Individuals, such as veterinary doctors, who come in contact with animals on a daily basis, have to take suitable safety measures before treating the infected animals

What is the Prognosis of Pneumonic Plague? (Outcomes/Resolutions)

• With early diagnosis and proper (and immediate) treatment, it is possible to treat Pneumonic Plague effectively. The prognosis of the infection in such cases is good
• Without treatment, the infection can cause death in a majority (or almost all) of the infected individuals

Additional and Relevant Useful Information for Pneumonic Plague:

Among the 3 types of Plague, Septicemic Plague is the rarest and affects fewer individuals than either Bubonic or Pneumonic Plague.