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Bubonic plague

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Bubonic plague is one of three types of plague caused by the plague bacterium (Yersinia pestis) from the Enterobacteriaceae family.[1] The Bubonic plague has been found to be the oldest and most widespread type of the plague and comprises 70-90% of the human cases of the plague.[2] Throughout history it is believed that over two hundred million people have died due to the plague.[3] Bubonic plague is now considered a re-emerging disease due to the increasing instances of antibiotic resistance.[4]

Cause

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The black rat ( Rattus rattus ) is the main reservoir species of the bubonic plague.

Bubonic plague is an infection of the lymphatic system, usually resulting from the bite of an infected flea, Xenopsylla cheopis (the Oriental rat flea) typically attached to Rattus or the Black Rat.[5]





Signs & Symptoms

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Symptoms include fever, headaches, swollen or inflamed lymph nodes, rapid on-set shortness of breath, gangrene, and buboes. Necrosis complications can lead to the death of extremity tissues causing dark discoloration of the skin.[6]

Diagnosis

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There are currently studies examining rapid diagnostic tests for the plague. One of the most promising tests is one that uses F1RDT to detect the plague and early tests have shown that for the Bubonic plague the test scored 100% for sensitivity and 67% for specificity compared to a culture.[7]

Prevention

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There is currently not an approved or effective vaccine to prevent being infected by Bubonic plague but multiple countries are currently testing live attenuated vaccines.[8]

Treatment

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From the type of fluoroquinones, Levofloxacin, a drug experimented on African green monkeys, has the ability to cure the plague. While in the experimentation phase, it was observed that after the first sign of fever in infected individuals, those who received the drug showed no signs of sickness. Simultaneously, the control group were almost always fatal.[9]It is also noted that this drug can be thought for curing other variations or instances of the plague.[9]

Epidemiology

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Global distribution of natural plague foci.

Although the plague has been present in numerous countries for the last few decades; it is endemic to the Democratic Republic of Congo, Peru and Madagascar.[10]


In the United States of America from 1970-2020, there were 496 total cases of the plague in humans. The majority of the cases were seen in the western region of the country; the largest number of cases reported in any state was in New Mexico which had a total of 253 cases during this time period. From 2000-2020 in the United States of America, 2006 holds the record for the greatest number of cases of the plague with a total of 17 cases; but the year with the greatest number of fatalities from the plague was 2015, which reported 4 deaths from the plague.[11]



History

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Plague doctor during the second pandemic.

Yersinia pestis, up to 6,000 years ago mutated from the Yersinia pseudotuberculosis bacterium. The plague first originated in Central or Eastern China within fleas infected with Yersinia pestis bacterium. The infectious fleas infected the black rat population would within those regions. During the 14th century the Mongolian Empire was transporting goods between Asia and Europe. Infectious rat climbed aboard their ships and were transported through the Mediterranean Sea to Europe. Handling the infectious rodents causes the Yersinia pestis bacterium to be transmitted from an animal vector to humans. With the arrival of the Plague being spread into the human population aboard the Mongolian ships it spread throughout Europe. The high virulent disease caused many outbreaks from the 14th century on, including the Plague of Justinian, the Black Death, and the third Plague in 1750.[12]

The second pandemic also produced individuals called "plague doctors", who wore masks and long black capes to protect them against the plague. Although this method of prevention was deeply flawed it is thought to be one of the first instances of hazmat suits in history.[13]



Society and culture

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Biological Warfare

Since the Cold War, The Centers for Disease Control and Prevention (CDC) have placed the Yersinia pestis (Y. pestis) bacterium as a Category A (tier 1) biological agent for potential bioterrorism.[14][15]

Continued research

A study has found that the Familial Mediterranean Fever (FMF) is a recessive disease typically seen in people from Turkey, Armenia and other groups located in Middle East and the plague are connected. Research has found that people with the recessive FMF mutation have also acquired plague immunity, this is similar to to those who have acquired immunity from Malaria because they have the Sickle Cell mutation. One of the groups that holds this mutations is Israeli Jews and many believe this mutation allowed many Jews during the Black Death to avoid catching the plague/having higher rates of surviving the disease; this is thought to have fueled the belief that Jews were to blame for spreading the disease.[16] During the Black Death, at least 235 Jewish communities were destroyed or attacked, due to the theories that Jews were responsible for the plague.[17]

References

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  1. ^ Wiechmann, Ingrid; Benedictow, Ole Jørgen; Bianucci, Raffaella; Kacki, Sacha (2012). "History of the Plague". RCC Perspectives (3): 63–74. ISSN 2190-5088.
  2. ^ Sebbane, Florent; Lemaître, Nadine (2021-05). "Antibiotic Therapy of Plague: A Review". Biomolecules. 11 (5): 724. doi:10.3390/biom11050724. ISSN 2218-273X. PMC 8151713. PMID 34065940. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  3. ^ Sun, Wei; Singh, Amit K. (2019-02-18). "Plague vaccine: recent progress and prospects". npj Vaccines. 4 (1): 1–9. doi:10.1038/s41541-019-0105-9. ISSN 2059-0105. PMC 6379378. PMID 30792905.{{cite journal}}: CS1 maint: PMC format (link)
  4. ^ Sun, Wei; Singh, Amit K. (2019-02-18). "Plague vaccine: recent progress and prospects". npj Vaccines. 4 (1): 1–9. doi:10.1038/s41541-019-0105-9. ISSN 2059-0105.
  5. ^ Mead, Paul S. (2015), "Yersinia Species (Including Plague)", Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Elsevier, pp. 2607–2618.e2, retrieved 2022-10-06
  6. ^ Ntuli, Tobias M., ed. (2015-12-16). "Cell Death - Autophagy, Apoptosis and Necrosis". doi:10.5772/59648. {{cite journal}}: Cite journal requires |journal= (help)
  7. ^ Jullien, Sophie; Dissanayake, Harsha A; Chaplin, Marty (2019-10-22). "Rapid diagnostic tests for plague". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd013459. ISSN 1465-1858.
  8. ^ Wang, Xiaoyi; Zhang, Xuecan; Zhou, Dongsheng; Yang, Ruifu (2013-06). "Live-attenuatedYersinia pestisvaccines". Expert Review of Vaccines. 12 (6): 677–686. doi:10.1586/erv.13.42. ISSN 1476-0584. {{cite journal}}: Check date values in: |date= (help)
  9. ^ a b Layton, Robert Colby; Mega, William; McDonald, Jacob D.; Brasel, Trevor L.; Barr, Edward B.; Gigliotti, Andrew P.; Koster, Frederick (2011-02-08). "Levofloxacin Cures Experimental Pneumonic Plague in African Green Monkeys". PLOS Neglected Tropical Diseases. 5 (2): e959. doi:10.1371/journal.pntd.0000959. ISSN 1935-2735. PMC 3035670. PMID 21347450.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  10. ^ "Plague". www.who.int. Retrieved 2022-12-10.
  11. ^ CDC (2022-11-16). "Plague surveillance | CDC". Centers for Disease Control and Prevention. Retrieved 2022-12-10.
  12. ^ Pennuto, Concetta (2009-11-11). "Pestilential complexities. Understanding medieval plague. Ed. by Vivian Nutton. London, The Wellcome Trust Centre for the History of Medicine at UCL, 2008 (Medical History, Supplement, no 27). 130 p. Ill. £ 35.–.; € 52.–. ISBN 978-0-85484-116-1". Gesnerus. 66 (1): 188–190. doi:10.1163/22977953-06601027. ISSN 0016-9161.
  13. ^ Glatter, Kathryn A.; Finkelman, Paul (2021-02-01). "History of the Plague: An Ancient Pandemic for the Age of COVID-19". The American Journal of Medicine. 134 (2): 176–181. doi:10.1016/j.amjmed.2020.08.019. ISSN 0002-9343. PMC 7513766. PMID 32979306.{{cite journal}}: CS1 maint: PMC format (link)
  14. ^ Ansari, Issmaeel; Grier, Gareth; Byers, Mark (2020-03). "Deliberate release: Plague – A review". Journal of Biosafety and Biosecurity. 2 (1): 10–22. doi:10.1016/j.jobb.2020.02.001. ISSN 2588-9338. {{cite journal}}: Check date values in: |date= (help)
  15. ^ "CDC | Bioterrorism Agents/Diseases (by category) | Emergency Preparedness & Response". emergency.cdc.gov. 2019-05-15. Retrieved 2022-10-06.
  16. ^ Glatter, Kathryn A.; Finkelman, Paul (2021-02-01). "History of the Plague: An Ancient Pandemic for the Age of COVID-19". The American Journal of Medicine. 134 (2): 176–181. doi:10.1016/j.amjmed.2020.08.019. ISSN 0002-9343.
  17. ^ Colet, Anna; Santiveri, Josep Xavier Muntané i; Ventura, Jordi Ruíz; Saula, Oriol; Galdàcano, M. Eulàlia Subirà de; Jáuregui, Clara (2015-01-01). "The Black Death and Its Consequences for the Jewish Community in Tàrrega: Lessons from History and Archeology". Pandemic Disease in the Medieval World: 63–96. doi:10.1017/9781942401018.005.