Plague is a rapidly progressing disease that can lead to death; immediate medical intervention is necessary once it is suspected or a diagnosis is made. It is a highly contagious disease, sometimes called the “black death” because of the several epidemics it caused in Europe in those days (medieval times).
Plague is a very old disease, it was first recognized about 1320 BC in Europe and it is said to have killed about 1 million people in 542 AD in Europe during one of the epidemics.
The disease occurs all around the world, but the risk of plague is highest in areas that have poor sanitation, overcrowding, and a large population of rodents. Consequently plague among human population is quite low today in developed countries; there are only 1,000 to 3,000 cases reported worldwide each year, with the highest incidence in Africa. Other areas where the disease could be found in some numbers today include South America and Asia; a developed country may not have up to 30 cases in a year. However, the largest number of infected animals is in the United States—mostly in Arizona, Colorado, and New Mexico. The former Soviet Union members also have a large population of infected animals.
The bacteria that cause plague are found in rats, mice, rodents, dogs, and other animals around the world and are carried by fleas from these animals to man. Outbreaks are therefore generally associated with infested rats and fleas in the home.
African counties with the highest number of plague cases include D.R. Congo, Madagascar, Uganda, Mozambique and Tanzania; in 2014 the disease claimed 40 lives in Madagascar.
Plague spreads from country to country through rats carried there by ships.
1. Plague is a highly contagious disease
Plague is a highly contagious disease, sometimes called the “black death” because of the several epidemics it caused in Europe in those days
There are three basic forms of plague.
Bubonic Plague:  The most common form of plague is bubonic plague. It is usually contracted when an infected rodent or flea bites you. In very rare cases, you can get the bacteria from material that has come into contact with an infected person. Bubonic plague infects your lymphatic system (immune system), causing inflammation. Untreated, it can move into the blood and cause septicemic plague, or to the lungs, causing pneumonic plague.
Pneumonic Plague: When the bacteria multiply in the lungs, you have pneumonic plague—the most serious form of the disease. When a person with pneumonic plague coughs, the bacteria from their lungs are expelled into the air. Other people who breathe that air can also develop this highly contagious form of plague, which can lead to an epidemic.
Septicemic Plague: When the bacteria multiply in the bloodstream, it is calledsepticemic plague. When untreated, both bubonic and pneumonic plague can lead to septicemic plague.
2. Plague is caused by a bacterium
Plague is caused by a bacterium called YERSINIA PESTIS which is easily killed by disinfectants, heat and sunlight but can survive in cold weather for weeks or months.
3. Plague spreads through bites by fleas and droplets
People usually get bubonic plague through the bite of fleas that have previously fed on infected animals like mice, rats, rabbits, squirrels, chipmunks, and prairie dogs. It can also be spread through direct contact with an infected person or animal, or by eating an infected animal. According to the National Institutes of health, bubonic plague can also spread through scratches or bites of infected domestic cats (NIH).
Bubonic plague can progress to pneumonic plague or septicaemic plague but like septicaemic plague cannot spread from person to the other.
Pneumonic plague spreads from one person to another by droplet infection; like when coughing or sneezing, those close can inhale the tiny discharges called droplets.
4. Symptoms of plague include fever, enlarged lymph nodes etc.
Symptoms depend on the type of plague the person has;
Symptoms of  bubonic  plague includes fever, headache, swollen lymph nodes and convulsions; these could appear after about 7 days after exposure to flea bite that has the bacteria.
Symptoms of pneumonic plague include chest pain, cough, fever, weakness and bloody sputum; these symptoms may appear within one day after exposure to the bacteria.
Septicaemic plague symptoms usually start within two to seven days after exposure, but septicaemic plague can lead to death before symptoms even appear. Symptoms can include abdominal pain, diarrhea, vomiting, fever, bleeding and shock.
You should think of plague and inform your doctor accordingly if you have the above symptoms and have been exposed to rodents or fleas, or if you have visited a region where plague is known to occur.
5. Plague is curable
If your doctor suspects you may have plague, he or she will look for the presence of the bacteria in your body by carrying some laboratory tests involving blood, lymph node fluid and sputum/respiratory tract fluid.
With no treatment, bubonic plague bacteria can multiply in the bloodstream, causing septicemic plague, or in the lungs, causing pneumonic plague. Death can occur within 24 hours after the appearance of the first symptom.
Treatment usually involves powerful antibiotics, intravenous fluids among others; the disease is curable
6. Possible Complications of plague include death etc
Without medical intervention, about 50 percent of people who have bubonic plague and almost 100 percent of people with pneumonic plague die, but treatment can reduce the death rate to less than 20 percent for both varieties. Plague can cause gangrene and sometimes meningitis an inflammation of membranes that surround your spinal cord and brain.
7. Plague is preventable
a. Keeping the rodent population under control can greatly reduce your risk of getting the bacteria that causes plague. Keep your home free from dirt/refuse heap/rubbish/other debris to discourage rats/rodents. Don’t leave pet food out and protect your pets from fleas. Use insect repellent products or natural insect repellants like citronella when spending time outdoors.
b. Chemotherapy for contacts: If you have been exposed to fleas during a plague outbreak, visit your doctor immediately so your concerns can be addressed quickly, anyone who has come into contact with pneumonic plague patients may be given antibiotics as a preventative measure.
c. Personal Hygeine: hand washing with soap and water followed by sanitizer. Use of face mask to reduce spread through droplets.
d. Barrier nursing; use of protective clothing and goggles when attending to cases of pneumonic plague
e. Regular fumigation of homes, inside and outside
f. A vaccine is available, but is only recommended as a preventative measure for high-risk groups (like health workers, relations of infected persons). Protection is less than a year.

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