Bubonic Plague

The headlines were gripping: two people were hospitalized in New York City in November 2002 with bubonic plague. Many people are familiar with bubonic plague as "the Black Death," the epidemic that killed millions of Europeans in the Middle Ages. Therefore, the New York City health commissioner had to reassure New Yorkers after the news broke about the hospitalized couple that no plague epidemic was occurring, and that the disease would not be spread from person to person.

What is it?
Bubonic plague is a potentially fatal bacterial infection. It causes swollen, tender lymph nodes, high fever, and chills. The infected person may develop serious illnesses such as pneumonia, blood poisoning, or meningitis.

How is it spread?
Bubonic plague is not spread from person to person. Small rodents such as rats, mice, and squirrels carry the infection. Fleas that live on these animals become infected, too, so people may get the bacteria from flea bites or from direct contact with an infected animal.

Does it still occur in the world?
According to the CDC there are 1,000 to 2,000 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, southwestern United States, the Andes mountains, and Brazil.

How is it treated?
Treatment of bubonic plague should begin as soon as the disease is diagnosed. Antibiotics such as streptomycin or tetracycline drugs are given, and symptoms are treated.

There is also a vaccination available for people working in or traveling to plague-affected areas of the world.

Can it be prevented?
The "Black Death" of the Middle Ages was due to large numbers of flea-ridden rats infesting homes and workplaces. In most developed countries, cities and towns have successfully controlled their rat populations, but rural and urban areas of developing countries often have problems with rat infestation, and thus are at risk of bubonic plague epidemics. Therefore, reducing the risk of plague outbreaks in these areas would require:

• Controlling the rat population
• Watching for plague cases in both rats and humans in the area
• Using insecticide to reduce the number of fleas
• Treating pets for fleas

Using these measures, public health workers and residents can help make areas threatened by bubonic plague safe for the people who live and work there.

Information for this article was taken from:
- National Organization for Rare Disorders. Bubonic Plague.
- Centers for Disease Control. CDC Plague Home Page.
- CNN.com/Health. Bubonic plague suspected in NYC visitors. November 7, 2002.