Occurence of Bubonic Plague

Turns out, the plague isn’t just ancient history. New Mexico health officials recently confirmed the first human case of bubonic plague — previously known as the “Black Death” — to surface in the U.S. in 2011.

An unidentified 58-year-old man was hospitalized for a week after suffering from a high fever, pain in his abdomen and groin, and swollen lymph nodes, reports the New York Daily News. (Officials declined to say when the man was released from the hospital.) A blood sample from the man tested positive for the disease.

According to the World Health Organization, there are 1,000 to 3,000 cases of bubonic plague worldwide each year. There are no known cases in Australia or Europe. Areas where cases occur are in Russia, the Middle East, China, Southwest and Southeast Asia, Madagascar, southern and eastern Africa, the Andes mountains and Brazil.

The U.S. Centers for Disease Control and Prevention (CDC) reports that there are 10 to 15 cases of bubonic plague in the United States each year. These cases tend to occur in two regions: northern New Mexico, northern Arizona and southern Colorado; California, southern Oregon and far western Nevada.

Etiology of Bubonic Plague

The plague is caused by a bacteria named Yersinia pestis. The most common type of plague is the bubonic plague and is spread through flea bites. The bubonic plague is not common in humans. The bacteria usually infects squirrels, rabbits and prairie dogs. People who handle these animals, especially if the animals are wild, are at risk of being bit by their fleas which are carrying the bacteria. The bacteria can also enter a cut in the skin of a person who handles an infected animal. Domestic cats that are allowed to roam outside can come in contact with wild animals with the bacterial infection and then spread it to humans.

People can get the plague when they are bitten by a flea that carries the plague bacteria from an infected rodent. In rare cases, you may get the disease when handling an infected animal.

A plague lung infection called pneumonic plague can spread from human to human. When someone with pneumonic plague coughs, tiny droplets carrying the bacteria move through the air. Anyone who breathes in these particles may catch the disease. An epidemic may be started this way.

In the Middle Ages in Europe, massive plague epidemics killed millions of people. Plague can still be found in Africa, Asia, and South America.

Today, plague is rare in the United States, but it has been known to occur in parts of California, Arizona, Colorado, and New Mexico.

There three most common forms of plague are:

• Bubonic plague -- an infection of the lymph nodes
• Pneumonic plague -- an infection of the lungs
• Septicemic plague -- an infection of the blood

The time between being infected and developing symptoms is typically 2 to 7 days, but may be as short as 1 day for pneumonic plague.

Risk factors for plague include a recent flea bite and exposure to rodents, especially rabbits, squirrels, or prairie dogs, or scratches or bites from infected domestic cats.

Signs and Symptoms of Bubonic Plague

The most infamous symptom of bubonic plague is an infection of the lymph glands (lymphadenitis), which become swollen and painful and are known as buboes. After being transmitted via the bite of an infected flea the Y. pestis bacteria become localized in an inflamed lymph node where they begin to colonize and reproduce. Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral, and groin and neck region. Acral gangrene (i.e. of the fingers, toes, lips and nose), is another common symptom.

Due to its bite-based form of infection, the bubonic plague is often the first step of a progressive series of illnesses. Bubonic plague symptoms appear suddenly, usually 2–5 days after exposure to the bacteria. Symptoms include:

• Acral gangrene: Gangrene of the extremities such as toes, fingers, lips and tip of the nose.
• Chills
• General ill feeling (malaise)
• High fever (39 °Celsius; 102 °Fahrenheit)
• Muscle Cramps
• Seizures
• Smooth, painful lymph gland swelling called a buboe, commonly found in the groin, but may occur in the armpits or neck, most often at the site of the initial infection (bite or scratch)
• Pain may occur in the area before the swelling appears
• Skin color changes to a pink hue in some very extreme cases

Other symptoms include heavy breathing, continuous vomiting of blood (hematemesis), aching limbs, coughing, and extreme pain. The pain is usually caused by the decay or decomposition of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, lenticulae (black dots scattered throughout the body), delirium and coma.

Two other types of Y. pestis plague are pneumonic and septicemic. Pneumonic plague, unlike the bubonic or septicemic, induces coughing and is very infectious, allowing it to be spread person to person.

Bubonic Plague Overview

A person with the bubonic plague has a serious infection caused by the bacteria, Yersinia pestis. The bacteria is transmitted to humans by rat flees, ticks and lice, but can also be spread from infected animals. The most common symptom is tender, swollen lymph glands. The bacteria can infect the skin, throat, lungs or brain. Bubonic plague is very rare: less than 10 cases of plague occur in the US each year.

What is bubonic plague?

Bubonic plague is a zoonotic disease, circulating mainly among small rodents and their fleas, and is one of three types of bacterial infections caused by Yersinia pestis (formerly known as Pasteurella pestis), which belongs to the family Enterobacteriaceae. Without treatment, the bubonic plague kills about two thirds of infected humans within 4 days.

The term bubonic plague is derived from the Greek word βουβών, meaning "groin." Swollen lymph nodes (buboes) especially occur in the armpit and groin in persons suffering from bubonic plague. Bubonic plague was often used synonymously for plague, but it does in fact refer specifically to an infection that enters through the skin and travels through the lymphatics, as is often seen in flea-borne infections.

Bubonic plague—along with the septicemic plague and the pneumonic plague, which are the two other manifestations of Y. pestis—is generally believed to be the cause of the Black Death that swept through Europe in the 14th century and killed an estimated 25 million people, or 30–60% of the European population. Because the plague killed so many of the working population, wages rose and some historians have seen this as a turning point in European economic development.