The plague
Plague is an acute infectious disease that is listed as a particularly dangerous infection. There are several forms of plague manifestations – inflammation of lymph nodes, lung damage, the development of hemorrhagic and septic processes.
ETIOLOGY AND PATHOGENESIS
The causative agent of the plague is a stationary gram-negative rod, Ersinia pestis, which is anaerbic, that is, capable of living in the absence of oxygen. Yersinia is considered particularly dangerous due to the fact that it retains its viability for a long time in the environment, as well as in the biological environments of sick people. For example, in bubonic pus, the pathogen persists for up to 30-35 days, and in decomposing corpses of humans and animals, the period reaches 3 months.
Another factor is the ability of yersinia to survive even at critically low temperatures. Despite this, the bacterium quickly dies under the influence of external factors – under the influence of sunlight, disinfectants, temperature changes up.
The natural reservoir for the pathogen is wild rodents (mice, voles, marmots, gerbils, in urban conditions – rats). Corpses are also the object of infection. The diseases are mainly carried by fleas and ticks.
The mechanism of infection is transmissible (when bitten by ticks and fleas, as well as when rubbing their excrement), contact-household (in direct interaction with a corpse, as well as when bacteria gets on damaged skin), alimentary (when eating meat of infected animals).
The contagiousness of the disease is extremely high, affects absolutely all age groups of the population. Immunity develops relative and does not protect against subsequent possible infection, however, subsequent cases of the disease occur in a milder form.
classification
The classification of the plague is based on the defeat of certain organs and systems:
Local
Generalizoannaya
Bubonic
Pulmonary
Skin-bubonic
Bubonic
Septic – primary and secondary
Intestinal
The most severe and almost 100% lethal is the intestinal form, in second place is the pulmonary one.
symptoms
The incubation period – there are no symptoms, lasts for 9 days, on average – 4-5 days. In the case of mass outbreaks or even an epidemic, the incubation period is reduced to one and a half to two days.
The period of the height of the disease begins acutely. A severe fever develops, with a terrific chill. Intoxication syndrome is severe, the patient’s condition is sharply worsened.
Patients present the following complaints: nausea, vomiting, which does not bring relief, a constant feeling of thirst, myalgia (muscle pain), arthralgia (joint pain).
Objectively, psychomotor agitation of patients is noted, as well as a change in the mental state – delirium, hallucinations, impaired coordination, speech is disturbed. In rare cases, lethargy, apathy, asthenic syndrome develops.
When examining patients, the following symptoms can be detected: hyperemia and swelling of the face, hemorrhagic rashes, tachycardia, dry mouth, tongue overlaid with a white coating. With the further development of the disease, diuresis decreases, up to oliguria, blood pressure is sharply reduced, infectious and toxic shock develops.
At the next stage of the disease, the clinical picture differs depending on the form that has developed in the patient. Thus, with a cutaneous form, a carbuncle develops on the patient’s skin, which is complicated by the development of a deep characteristic ulcer – with a black scab in the middle. The ulcer heals for a long time, leaving ugly scars.
The bubonic form is characterized by the development of inflammation in the lymph nodes, which are inflamed in most cases by single elements. Bubons increase in size, inflamed lymph nodes are tightly soldered to the surrounding tissues, painful. As a rule, the bubo is opened, but self-absorption is also possible.
Septic forms develop at lightning speed and, if medical care is not provided, they end in death. The intestinal form is characterized by the development of sharp acute abdominal pain, symptoms of peritonitis and severe intoxication syndrome, diarrhea.
diagnostics
Histological, serological examination of the biological material of infected
Blood and urine analysis
Lung radiography – signs of pneumonia
treatment
The main type of treatment is antibacterial therapy and symptomatic treatment. In the cutaneous form, cotrimoxazole is used, bubonic – levomycetin (intravenously jet), streptomycin, tetracycline antibiotics.
Detoxification measures, infusion therapy of hemodesis, polydesis, rheopolyglucine, crystalloid solutions are also carried out, drugs that improve microcirculation are used. If there are indications, cardiovascular, bronchodilator and other drugs are prescribed
