Does Plague Still Exist?

Plague is a bacterial infection passed by fleas infected with Yersinia pestis, and it is believed to be the agent responsible for pandemics such as the Black Death of the 1300s. Many people are surprised to learn that Yersinia pestis is in fact still active in the modern day. The Centers for Disease Control and Prevention, based in Atlanta, Georgia, document between one and two thousand cases of plague yearly around the world. Fortunately, modern medical treatments can be used to address the situation and cure the patient, assuming that the plague is caught early enough.

In some parts of the world, plague is considered to be endemic, meaning that it cannot be eradicated. These areas include China, the American Southwest, the Andes mountains, and parts of Africa. Plague has also been documented in other regions, including the Midwest, Russia, and Southeast Asia. In these regions, citizens are advised to be extremely careful around wild animals such as rats which can carry infected fleas, and to use proper flea control on their pets to avoid bringing plague into the house. In the Midwest especially, several plague cases each year are linked to domestic cats.

The vast majority of modern plague cases take the classic form of bubonic plague, which causes swollen lymph nodes which are readily apparent to the observer, forming lumps or buboes under the skin. It is accompanied with chills, fever, headache, and general malaise, and can cause death if untreated. However, bubonic plague cannot be passed from person to person; a carrier animal, such as a flea, must be present in order for someone else to contract the infection. If treated properly with antibiotics, the patient can make a full recovery.

A more unusual form of plague is septicemic plague, which occurs when the bacteria infest the bloodstream directly. It can rapidly spread to internal organs, causing internal bleeding, and it is difficult to diagnose. If left untreated, bubonic plague will turn septicemic as the buboes ulcerate and burst. This form of plague also cannot be passed directly from person to person.

The most dangerous form of plague is pneumonic plague, which infects the lungs, and can be passed from the patient to others as he or she breathes. It is also more virulent than other forms of plague, and patients can die before the classic buboes indicating plague infection ever appear. Patients who live in or have visited areas in which plague is endemic and present with fever, chills, shortness of breath, and bloody phlegm should be examined for pneumonic plague, to rule it out before moving on to testing for other diseases.