Pneumonic plague

Pneumonic plague is a severe lung infection caused by the bacterium Yersinia pestis. Symptoms include fever, headache, shortness of breath, chest pain, and coughing. They typically start about three to seven days after exposure. It is one of three forms of plague, the other two being septicemic plague and bubonic plague.

Pneumonic plague
A scanning electron micrograph depicting a mass of Yersinia pestis bacteria
SpecialtyInfectious disease
SymptomsFever, headache, shortness of breath, cough, hemoptysis
Usual onset3 to 7 days
CausesYersinia pestis
Risk factorsRodents
Diagnostic methodSputum testing
TreatmentAntibiotics
PrognosisA case-fatality ratio of 30% to 60% for the bubonic type, and invariably fatal for the pneumonic kind when left untreated.
FrequencyRare

The pneumonic form may occur following an initial bubonic or septicemic plague infection. It may also result from breathing in airborne droplets from another person or animal infected with pneumonic plague. The difference between the forms of plague is the location of infection; in pneumonic plague the infection is in the lungs, in bubonic plague the lymph nodes, and in septicemic plague within the blood. Diagnosis is by testing the blood, sputum, or fluid from a lymph node.

While vaccines are being developed, in most countries they are not yet commercially available. Prevention is by avoiding contact with infected rodents, people, or cats. It is recommended that those infected be isolated from others. Treatment of pneumonic plague is with antibiotics.

Plague is present among rodents in Africa, the Americas, and Asia. Pneumonic plague is more serious and less common than bubonic plague. The total reported number of cases of all types of plague in 2013 was 783. Left untreated, pneumonic plague is always fatal. Some hypothesize that the pneumonic version of the plague was mainly responsible for the Black Death that resulted in approximately 75 - 200 million deaths in the 1300s.

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