Plague (cont.)

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What is the treatment for the plague? What is the prognosis of the plague?

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Currently, plague is treated with antibiotics. The following antibiotics have been used to successfully treat plague if the person's disease has not yet overwhelmed the body's defenses (earlier treatments have a better chance to stop the disease):

  • Streptomycin
  • Gentamicin (Garamycin)
  • Chloramphenicol
  • Tetracyclines (Sumycin)
  • Fluoroquinolones

Patients who are suspected of being exposed to plague should be treated immediately. The antibiotic, route of administration (IV or oral), duration of treatment and supportive care, if necessary, are determined by the patient's caregiver and usually in consultation with CDC or infectious-disease specialists. Plague is rarely seen in the U.S. (about 13 infections are diagnosed per year with one recent year with 40 diagnosed); however, about 14% of people who are diagnosed in the U.S. still die from the disease. The World Health Organization estimates about 2,900 individuals per year are diagnosed with plague currently.

The prognosis of untreated plague is poor. About 50%-90% of infected individuals will die if untreated. Even with appropriate treatment, about 14% of treated patients will still die from the disease. Those patients who recover may have sustained damage to one or more organs such as the lungs.

How can plague be prevented?

The CDC provides the following preventive recommendations related to zoonosis diseases caused by rodents and their vectors, including plague:

  • Watch for plague activity in rodent populations where plague is known to occur. Report any observations of sick or dead animals to the local health department or law-enforcement officials.
  • Eliminate sources of food and nesting places for rodents around homes, work places, and recreation areas; remove brush, rock piles, junk, cluttered firewood, and potential food supplies, such as pet and wild animal food. Make your home rodent-proof.
  • If you anticipate being exposed to rodent fleas, apply insect repellents to clothing and skin, according to label instructions, to prevent flea bites. Wear gloves when handling potentially infected animals.
  • If you live in areas where rodent plague occurs, treat pet dogs and cats for flea control regularly and do not allow these animals to roam freely.
  • Health authorities may use appropriate chemicals to kill fleas at selected sites during animal plague outbreaks.

Prophylactic (preventive) antibiotics: Health authorities advise that antibiotics be given for a brief period to people who have been exposed to the bites of potentially infected rodent fleas (for example, during a plague outbreak) or who have handled an animal known to be infected with the plague bacterium. Such experts also recommend that antibiotics be given if a person has had close exposure to a person or an animal (for example, a house cat) with suspected plague pneumonia. People who must be present in an area where a plague outbreak is occurring can protect themselves for two to three weeks by taking antibiotics. The preferred antibiotics for prophylaxis against plague are the tetracyclines or the sulfonamides. There is no commercially available vaccine against plague available in the U.S.

Medically Reviewed by a Doctor on 10/30/2013

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