Credit CDC
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In recent decades, with the wide availability of suitable antibiotics, bubonic plague epidemics have become a rarity. The last really big plague outbreak was in India nearly 20 years ago, as summarized by the WHO.
During August 26-October 5, 1994, a total of 5150 suspected pneumonic or bubonic plague cases and 53 deaths were reported from eight states of India, primarily in the south-central and southwestern regions.
Although reports of plague were initially denied by Indian officials, the mass exodus of hundreds of thousands of panicked people from Surat spread the disease to 7 Indian states.
You can read Newsweek’s contemporaneous coverage of this event in The Plague of Panic.
Worldwide, on average, anywhere between 1,000 and 3,000 cases are reported each year, but most are isolated infections or (more rarely) small clusters.
Bubonic Plague (Yersinia Pestis) is a bacterial infection transmitted by fleas, carried by infected rats. The infection generally sets up in the lymphatic system, resulting in the tell-tale buboes, or swollen lymph glands in the the groin, armpits, and neck.
Credit CDC
In rare cases Pneumonic Plague may develop. Here the infected person develops a severe pneumonia, with coughing and hemoptysis (expectoration of blood), and may spread the disease from human-to-human.
The last major urban outbreak of plague in the United States occurred in 1924-25 in Los Angeles. Since then, only scattered cases have been reported, with about 10-15 cases each year.
Which brings us to a series of news reports this morning out of Kyrgyzstan that indicates a 15-year old boy has died from bubonic plague, at least 100 contacts have been hospitalized and `quarantined’, and antibiotics are being distributed in the area.
The details vary between reports, and so a small smattering of the coverage follows:
First from Aljazeera:
Kyrgyzstan boy dies of bubonic plague
Health officials confirm 15-year-old's death was caused by the rodent-borne disease, but say an epidemic is unlikely.
Last Modified: 27 Aug 2013 05:12
Doctors in Kyrgyzstan have said a teenage boy has died of bubonic plague, but that an epidemic is not likely.
The death of the 15-year-old herder was confirmed on Monday, several days after his death in the Karakol regional hospital.
Health ministers said the boy, from the small mountain village Ichke-Zhergez in eastern Kyrgyzstan, died last Thursday after being diagnosed with bubonic plague, which is carried by rodents and caused millions of deaths throughout Europe in the 14th century.
The BBC reports:
Boy dies of plague in Kyrgyzstan
A 15-year-old herder has died in Kyrgyzstan of bubonic plague - the first case in the country in 30 years - officials say.
The teenager appears to have been bitten by an infected flea.
The authorities have sought to calm fears of an epidemic and have quarantined more than 100 people.
Other reports, such as this one from RIA Novosti, link the boy’s infection to the consumption of a barbecued marmot.
Kyrgyzstan on Plague Watch After Man Dies From Rodent Meal
Whatever the vector, the good news is that bubonic plague usually responds well to modern medical treatment. This from the CDC:
How is plague treated?
Plague can be successfully treated with antibiotics. Once a patient is diagnosed with suspected plague they should be hospitalized and, in the case of pneumonic plague, medically isolated. Laboratory tests should be done, including blood cultures for plague bacteria and microscopic examination of lymph node, blood, and sputum samples. Antibiotic treatment should begin as soon as possible after laboratory specimens are taken. To prevent a high risk of death in patients with pneumonic plague, antibiotics should be given as soon as possible, preferably within 24 hours of the first symptoms.
Without treatment, however, mortality rates run 40%-60%. Untreated, pneumonic plague is almost always fatal.
As long as the locals don’t flee, as we saw in India 20 years ago, and they take the antibiotics being dispensed, a localized epidemic of plague is unlikely.
For more on Plague, you may wish to visit the CDC’s Plague Website.
