understanding-plague-a-modern-family-doctor-s-guide
Title: Understanding Plague: A Modern Family Doctor's Guide
Overview: Plague, caused by Yersinia pestis, is a severe infectious disease that has been a concern for public health. This article, adapted from Chinese medical guidance, provides a comprehensive overview of plague, including its symptoms, diagnosis, treatment, and prevention measures.
The Basics of Plague: Plague is an acute, severe, and sometimes fatal infectious disease caused by the bacterium Yersinia pestis. It is classified as a Class A notifiable disease in China. The bacterium is Gram-negative, oval, and measures approximately 1-1.5 micrometers in length and 0.5-0.7 micrometers in width. It thrives at temperatures between 28-30°C and can be killed by direct sunlight for 4-5 hours, heat at 55°C for 15 minutes or 100°C for 1 minute, and disinfectants like 5% phenol, 5% cresol soap, 0.1% mercuric chloride, and 5-10% chloramine.
Transmission and Hosts: Plague primarily affects rodents, marmots, and other rodents, making it a typical zoonotic disease. Rats and marmots are the reservoir hosts, with the brown rat and the yellow chest rat being the main sources of human infection. Other animals such as cats, sheep, rabbits, camels, wolves, and foxes can also act as reservoirs. The disease is mainly spread to humans through infected fleas and respiratory droplets.
Symptoms and Diagnosis: The incubation period for plague ranges from 2-5 days for bubonic plague, a few hours to 3 days for primary pneumonic plague, and up to 9-12 days for those who have received prophylactic vaccination. Symptoms include high fever, chills, severe headache, and sometimes central vomiting, tachycardia, hypotension, and delirium. Bubonic plague presents with lymphadenopathy, while pneumonic plague manifests with coughing up blood and difficulty breathing. Diagnosis involves blood tests, sputum and pus culture, and serological tests.
Treatment: Treatment should be early, combined, and adequate, using sensitive antibacterial drugs. Commonly used antibiotics include streptomycin, gentamicin, tetracycline, chloramphenicol, and ciprofloxacin. Supportive care, such as oxygen therapy and fluid replacement, is also crucial.
Prevention: Preventive measures include rodent and flea control, strict isolation of patients, and international and domestic travel检疫. Healthcare workers entering plague-endemic areas should wear protective gear and receive prophylactic medication. Vaccination is recommended for individuals in plague-endemic areas and healthcare workers.
Conclusion: Plague remains a significant public health threat. Understanding its transmission, symptoms, diagnosis, treatment, and prevention is crucial for healthcare providers and the public. Early detection and prompt treatment are essential to prevent severe illness and death.