The plague begins. Plague - symptoms of the disease, prevention and treatment of the Plague, causes of the disease and its diagnosis on EUROLAB

The culprits of the most massive deaths in history are not the politicians who started the wars. Pandemics of terrible diseases were the causes of the most widespread death and suffering of people. How did it happen and where is plague, smallpox, typhus, leprosy, cholera now?

PLAGUE

Historical facts about the plague

The plague pandemic brought the most massive mortality in the middle of the 14th century, sweeping across Eurasia and, according to the most conservative estimates of historians, killing 60 million people. If we consider that at that time the world's population was only 450 million, then one can imagine the catastrophic scale of the “Black Death,” as this disease was called. In Europe, the population decreased by about a third, and the labor shortage was felt here for at least another 100 years, farms were abandoned, the economy was in a terrible state. In all subsequent centuries, major outbreaks of plague were also observed, the last of which was noted in 1910-1911 in the northeastern part of China.

Origin of the name of the plague

The names come from Arabic. The Arabs called the plague “jummah,” which translated means “ball” or “bean.” The reason for this was the appearance of the inflamed lymph node of a plague patient - the bubo.

Methods of spread and symptoms of plague

There are three forms of plague: bubonic, pneumonic and septicemic. All of them are caused by one bacterium, Yersinia pestis, or, more simply, the plague bacillus. Its carriers are rodents with anti-plague immunity. And the fleas that have bitten these rats, also through a bite, transmit it to humans. The bacterium infects the flea's esophagus, as a result of which it becomes blocked, and the insect becomes eternally hungry, bites everyone and immediately infects it through the resulting wound.

Methods of combating plague

In medieval times, plague-inflamed lymph nodes (buboes) were cut out or cauterized, opening them. Plague was considered a type of poisoning in which some poisonous miasma entered the human body, so treatment consisted of taking antidotes known at that time, for example, crushed jewelry. Nowadays, the plague is successfully overcome with the help of common antibiotics.

The plague is now

Every year, about 2.5 thousand people become infected with the plague, but this is no longer in the form of a mass epidemic, but cases all over the world. But the plague bacillus is constantly evolving, and old medicines are not effective. Therefore, although everything, one might say, is under the control of doctors, the threat of catastrophe still exists today. An example of this is the death of a person registered in Madagascar in 2007 from a strain of the plague bacillus, in which 8 types of antibiotics did not help.

SMALLPOX

Historical facts about smallpox

During the Middle Ages, there were not many women who did not have signs of smallpox lesions on their faces (pockmarks), and the rest had to hide the scars under a thick layer of makeup. This influenced the fashion of excessive interest in cosmetics, which has survived to this day. According to philologists, all women today with letter combinations in their surnames “ryab” (Ryabko, Ryabinina, etc.), shadar and often generous (Shchedrins, Shadrins), Koryav (Koryavko, Koryaeva, Koryachko) had ancestors sporting pockmarks (rowans, generous, etc., depending on the dialect). Approximate statistics exist for the 17th-18th centuries and indicate that in Europe alone there were 10 million new smallpox patients, and for 1.5 million of them it was fatal. Thanks to this infection, the white man colonized both Americas. For example, the Spaniards brought smallpox to Mexico in the 16th century, because of which about 3 million of the local population died - the invaders had no one left to fight with.

Origin of the name smallpox

“Smallpox” and “rash” have the same root. In English, smallpox is called smallpox. And syphilis is called a great rash (great pox).

Methods of spread and symptoms of smallpox

After entering the human body, smallpox varionas (Variola major and Variola) lead to the appearance of blisters-pustules on the skin, the places of formation of which then scar, if the person survives, of course. The disease spreads through airborne droplets, and the virus also remains active in scales from the skin of an infected person.

Methods to combat smallpox

The Hindus brought rich gifts to the smallpox goddess Mariatela to appease her. Residents of Japan, Europe and Africa believed in the smallpox demon's fear of the color red: patients had to wear red clothes and be in a room with red walls. In the twentieth century, smallpox began to be treated with antiviral drugs.

Smallpox in modern times

In 1979, WHO officially announced that smallpox had been completely eradicated thanks to vaccination of the population. But in countries such as the USA and Russia, pathogens are still stored. This is done “for scientific research,” and the question of the complete destruction of these reserves is constantly being raised. It is possible that North Korea and Iran are secretly storing smallpox virions. Any international conflict could give rise to the use of these viruses as weapons. So it's better to get vaccinated against smallpox.

CHOLERA

Historical facts about cholera

Until the end of the 18th century, this intestinal infection largely bypassed Europe and raged in the Ganges delta. But then there were changes in climate, invasions of European colonialists in Asia, transportation of goods and people improved, and this all changed the situation: in 1817-1961, six cholera pandemics occurred in Europe. The most massive one (the third) took the lives of 2.5 million people.

Origin of the name cholera

The words “cholera” come from the Greek “bile” and “flow” (in reality, all the fluid from the inside flowed out of the patient). The second name for cholera due to the characteristic blue color of the skin of patients is “blue death”.

Methods of spread and symptoms of cholera

Vibrio cholera is a bacterium called Vibrio choleare that lives in water bodies. When it enters the small intestine of a person, it releases enterotoxin, which leads to profuse diarrhea and then vomiting. In severe cases of the disease, the body becomes dehydrated so quickly that the patient dies a few hours after the first symptoms appear.

Methods to combat cholera

They applied samovars or irons to the feet of the sick to warm them, gave them chicory and malt infusions to drink, and rubbed their bodies with camphor oil. During the epidemic, they believed that it was possible to scare away the disease with a belt made of red flannel or wool. Nowadays, people with cholera are effectively treated with antibiotics, and for dehydration they are given oral fluids or special salt solutions are administered intravenously.

Cholera now

WHO says the world is now in its seventh cholera pandemic, dating back to 1961. So far, it is mainly residents of poor countries who get sick, primarily in South Asia and Africa, where 3-5 million people get sick every year and 100-120 thousand of them do not survive. Also, according to experts, due to global negative changes in the environment, serious problems with clean water will soon arise in developed countries. In addition, global warming will cause cholera outbreaks in nature to appear in more northern regions of the planet. Unfortunately, there is no vaccine against cholera.

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Historical facts about typhus

Until the second half of the 19th century, this was the name given to all diseases in which severe fever and confusion were observed. Among them, the most dangerous were typhus, typhoid and relapsing fever. Sypnoy, for example, in 1812 almost halved Napoleon’s 600,000-strong army, which invaded Russian territory, which was one of the reasons for his defeat. And a century later, in 1917-1921, 3 million citizens of the Russian Empire died of typhus. Relapsing fever mainly caused grief to the inhabitants of Africa and Asia; in 1917-1918, about half a million people in India alone died from it.

Origin of the name typhus

The name of the disease comes from the Greek “typhos”, which means “fog”, “confused consciousness”.

Methods of spread and symptoms of typhus

Typhus causes small pink rashes on the skin. When the attack returns after the first attack, the patient seems to feel better for 4-8 days, but then the disease knocks him down again. Typhoid fever is an intestinal infection that is accompanied by diarrhea.

The bacteria that cause typhus and relapsing fever are carried by lice, and for this reason, outbreaks of these infections break out in crowded places during humanitarian disasters. When bitten by one of these creatures, it is important not to itch – it is through scratched wounds that the infection enters the blood. Typhoid fever is caused by the Salmonella typhi bacillus, which, when ingested through food and water, leads to damage to the intestines, liver and spleen.

Methods to combat typhus

During the Middle Ages, it was believed that the source of infection was the stench that emanated from the patient. Judges in Britain who had to deal with criminals with typhus wore boutonnieres of strong-smelling flowers as a means of protection, and also distributed them to those who came to court. The benefit from this was only aesthetic. Since the 17th century, attempts have been made to combat typhus with the help of cinchona bark, imported from South America. This is how they treated all diseases that caused fever. Nowadays, antibiotics are quite successful in treating typhus.

Typhoid in now

Relapsing fever and typhus were removed from the WHO list of particularly dangerous diseases in 1970. This happened thanks to the active fight against pediculosis (lice), which was carried out throughout the planet. But typhoid fever continues to cause troubles for people. The most suitable conditions for the development of an epidemic are heat, insufficient drinking water and problems with hygiene. Therefore, the main candidates for the outbreak of typhoid epidemics are Africa, South Asia and Latin America. According to experts from the Ministry of Health, every year 20 million people become infected with typhoid fever and for 800 thousand of them it is fatal.

LEPROSY

Historical facts about leprosy

Also called leprosy, it is a “slow disease.” Unlike the plague, for example, it did not spread in the form of pandemics, but quietly and gradually conquered space. At the beginning of the 13th century, there were 19 thousand leper colonies in Europe (an institution for isolating lepers and fighting the disease) and the victims were millions. By the beginning of the 14th century, the mortality rate from leprosy had dropped sharply, but hardly because they had learned to treat patients. It’s just that the incubation period for this disease is 2-20 years. Infections like plague and cholera that raged in Europe killed many people even before he was classified as a leper. Thanks to the development of medicine and hygiene, there are now no more than 200 thousand lepers in the world. They mainly live in the countries of Asia, Africa and Latin America.

Origin of the name leprosy

The name comes from the Greek word “leprosy,” which translates to “a disease that makes the skin scaly.” Leprosy was called in Rus' - from the word “kazit”, i.e. lead to distortion and disfigurement. This disease also has a number of other names, such as Phoenician disease, “lazy death”, Hansen’s disease, etc.

Methods of spread and symptoms of leprosy

It is possible to become infected with leprosy only by long-term contact with the skin of a carrier of the infection, as well as by ingestion of liquid secretions (saliva or from the nose). Then quite a long time passes (the recorded record is 40 years), after which the Hansen bacillus (Mucobacterium leprae) first disfigures the person, covering him with spots and growths on the skin, and then makes him an invalid rotting alive. Also, the peripheral nervous system is damaged and the patient loses the ability to feel pain. You can take and cut off a part of your body without understanding where it went.

Methods to combat leprosy

During the Middle Ages, lepers were declared dead while they were still alive and placed in leprosariums - a kind of concentration camps, where patients were doomed to a slow death. They tried to treat the infected with solutions that included gold, bloodletting and baths with the blood of giant turtles. Nowadays, this disease can be completely eliminated with the help of antibiotics.

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The Black Death is a disease that is currently the subject of legends. This is actually the name given to the plague that struck Europe, Asia, North Africa and even Greenland in the 14th century. The pathology proceeded mainly in the bubonic form. The territorial focus of the disease has become where this place is, many people know. The Gobi belongs to Eurasia. The Black Sea arose precisely there due to the Little Ice Age, which served as an impetus for sudden and dangerous climate change.

It took the lives of 60 million people. Moreover, in some regions the death toll reached two-thirds of the population. Due to the unpredictability of the disease, as well as the impossibility of curing it at that time, religious ideas began to flourish among people. Belief in a higher power has become commonplace. At the same time, persecution began of the so-called “poisoners”, “witches”, “sorcerers”, who, according to religious fanatics, sent the epidemic to people.

This period remained in history as a time of impatient people who were overcome by fear, hatred, mistrust and numerous superstitions. In fact, of course, there is a scientific explanation for the outbreak of bubonic plague.

The Myth of the Bubonic Plague

When historians were looking for ways the disease could penetrate Europe, they settled on the opinion that the plague appeared in Tatarstan. More precisely, it was brought by the Tatars.

In 1348, led by Khan Dzhanybek, during the siege of the Genoese fortress of Kafa (Feodosia), they threw there the corpses of people who had previously died from the plague. After liberation, Europeans began to leave the city, spreading the disease throughout Europe.

But the so-called “plague in Tatarstan” turned out to be nothing more than a speculation of people who do not know how to explain the sudden and deadly outbreak of the “Black Death”.

The theory was defeated as it became known that the pandemic was not transmitted between people. It could be contracted from small rodents or insects.

This “general” theory existed for quite a long time and contained many mysteries. In fact, the plague epidemic, as it turned out later, began for several reasons.

Natural causes of the pandemic

In addition to dramatic climate change in Eurasia, the outbreak of bubonic plague was preceded by several other environmental factors. Among them:

• global drought in China followed by widespread famine;
• in Henan province massive;
• Rain and hurricanes prevailed in Beijing for a long time.

Like the Plague of Justinian, as the first pandemic in history was called, the Black Death struck people after massive natural disasters. She even followed the same path as her predecessor.

The decrease in people's immunity, provoked by environmental factors, has led to mass morbidity. The disaster reached such proportions that church leaders had to open rooms for the sick population.

The plague in the Middle Ages also had socio-economic prerequisites.

Socio-economic causes of bubonic plague

Natural factors could not provoke such a serious outbreak of the epidemic on their own. They were supported by the following socio-economic prerequisites:

• military operations in France, Spain, Italy;
• the dominance of the Mongol-Tatar yoke over part of Eastern Europe;
• increased trade;
• soaring poverty;
• too high population density.

Another important factor that provoked the invasion of the plague was a belief that implied that healthy believers should wash as little as possible. According to the saints of that time, contemplation of one’s own naked body leads a person into temptation. Some followers of the church were so imbued with this opinion that they never immersed themselves in water in their entire adult lives.

Europe in the 14th century was not considered a pure power. The population did not monitor waste disposal. Waste was thrown directly from the windows, slops and the contents of chamber pots were poured onto the road, and the blood of livestock flowed into it. This all later ended up in the river, from which people took water for cooking and even for drinking.

Like the Plague of Justinian, the Black Death was caused by large numbers of rodents that lived in close contact with humans. In the literature of that time you can find many notes on what to do in case of an animal bite. As you know, rats and marmots are carriers of the disease, so people were terrified of even one of their species. In an effort to overcome rodents, many forgot about everything, including their family.

How it all began

The origin of the disease was the Gobi Desert. The location of the immediate outbreak is unknown. It is assumed that the Tatars who lived nearby declared a hunt for marmots, which are carriers of the plague. The meat and fur of these animals were highly valued. Under such conditions, infection was inevitable.

Due to drought and other negative weather conditions, many rodents left their shelters and moved closer to people, where more food could be found.

Hebei province in China was the first to be affected. At least 90% of the population died there. This is another reason that gave rise to the opinion that the outbreak of the plague was provoked by the Tatars. They could lead the disease along the famous Silk Road.

Then the plague reached India, after which it moved to Europe. Surprisingly, only one source from that time mentions the true nature of the disease. It is believed that people were affected by the bubonic form of plague.

In countries that were not affected by the pandemic, real panic arose in the Middle Ages. The heads of the powers sent messengers for information about the disease and forced specialists to invent a cure for it. The population of some states, remaining ignorant, willingly believed rumors that snakes were raining on the contaminated lands, a fiery wind was blowing and acid balls were falling from the sky.

Low temperatures, a long stay outside the host's body, and thawing cannot destroy the causative agent of the Black Death. But sun exposure and drying are effective against it.

Bubonic plague begins to develop from the moment of being bitten by an infected flea. Bacteria enter the lymph nodes and begin their life activity. Suddenly, a person is overcome by chills, his body temperature rises, the headache becomes unbearable, and his facial features become unrecognizable, black spots appear under his eyes. On the second day after infection, the bubo itself appears. This is what is called an enlarged lymph node.

A person infected with the plague can be identified immediately. "Black Death" is a disease that changes the face and body beyond recognition. Blisters become noticeable already on the second day, and the patient’s general condition cannot be called adequate.

The symptoms of plague in a medieval person are surprisingly different from those of a modern patient.

Clinical picture of the bubonic plague of the Middle Ages

“Black Death” is a disease that in the Middle Ages was identified by the following signs:

• high fever, chills;
• aggressiveness;
• continuous feeling of fear;
• severe pain in the chest;
• dyspnea;
• cough with bloody discharge;
• blood and waste products turned black;
• a dark coating could be seen on the tongue;
• ulcers and buboes appearing on the body emitted an unpleasant odor;
• clouding of consciousness.

These symptoms were considered a sign of imminent and imminent death. If a person received such a sentence, he already knew that he had very little time left. No one tried to fight such symptoms; they were considered the will of God and the church.

Treatment of bubonic plague in the Middle Ages

Medieval medicine was far from ideal. The doctor who came to examine the patient paid more attention to talking about whether he had confessed than to directly treating him. This was due to the religious insanity of the population. Saving the soul was considered a much more important task than healing the body. Accordingly, surgical intervention was practically not practiced.

Treatment methods for plague were as follows:

• cutting tumors and cauterizing them with a hot iron;
• use of antidotes;
• applying reptile skin to the buboes;
• pulling out disease using magnets.

However, medieval medicine was not hopeless. Some doctors of that time advised patients to stick to a good diet and wait for the body to cope with the plague on its own. This is the most adequate theory of treatment. Of course, under the conditions of that time, cases of recovery were isolated, but they still took place.

Only mediocre doctors or young people who wanted to gain fame in an extremely risky way took on the treatment of the disease. They wore a mask that looked like a bird's head with a pronounced beak. However, such protection did not save everyone, so many doctors died after their patients.

Government authorities advised people to adhere to the following methods of combating the epidemic:

• Long distance escape. At the same time, it was necessary to cover as many kilometers as possible very quickly. It was necessary to remain at a safe distance from the disease for as long as possible.
• Drive herds of horses through contaminated areas. It was believed that the breath of these animals purifies the air. For the same purpose, it was advised to allow various insects into houses. A saucer of milk was placed in a room where a person had recently died of the plague, as it was believed to absorb the disease. Methods such as breeding spiders in the house and burning large numbers of fires near the living space were also popular.
• Do whatever is necessary to kill the smell of the plague. It was believed that if a person does not feel the stench emanating from infected people, he is sufficiently protected. That is why many carried bouquets of flowers with them.

Doctors also advised not to sleep after dawn, not to have intimate relations and not to think about the epidemic and death. Nowadays this approach seems crazy, but in the Middle Ages people found solace in it.

Of course, religion was an important factor influencing life during the epidemic.

Religion during the bubonic plague epidemic

"Black Death" is a disease that frightened people with its uncertainty. Therefore, against this background, various religious beliefs arose:

• The plague is a punishment for ordinary human sins, disobedience, bad attitude towards loved ones, the desire to succumb to temptation.
• The plague arose as a result of neglect of faith.
• The epidemic began because shoes with pointed toes came into fashion, which greatly angered God.

Priests who were obliged to listen to the confessions of dying people often became infected and died. Therefore, cities were often left without church ministers because they feared for their lives.

Against the background of the tense situation, various groups or sects appeared, each of which explained the cause of the epidemic in its own way. In addition, various superstitions were widespread among the population, which were considered the pure truth.

Superstitions during the bubonic plague epidemic

In any, even the most insignificant event, during the epidemic, people saw peculiar signs of fate. Some superstitions were quite surprising:

• If a completely naked woman plows the ground around the house, and the rest of the family members are indoors at this time, the plague will leave the surrounding areas.
• If you make an effigy symbolizing the plague and burn it, the disease will recede.
• To prevent the disease from attacking, you need to carry silver or mercury with you.

Many legends developed around the image of the plague. People really believed in them. They were afraid to open the door of their house again, so as not to let the plague spirit inside. Even relatives fought among themselves, everyone tried to save themselves and only themselves.

The situation in society

The oppressed and frightened people eventually came to the conclusion that the plague was being spread by so-called outcasts who wanted the death of the entire population. The pursuit of the suspects began. They were forcibly dragged to the infirmary. Many people who were identified as suspects committed suicide. An epidemic of suicide has hit Europe. The problem has reached such proportions that the authorities have threatened those who commit suicide by putting their corpses on public display.

Since many people were sure that they had very little time left to live, they went to great lengths: they became addicted to alcohol, looking for entertainment with women of easy virtue. This lifestyle further intensified the epidemic.

The pandemic reached such proportions that the corpses were taken out at night, dumped in special pits and buried.

Sometimes it happened that plague patients deliberately appeared in society, trying to infect as many enemies as possible. This was also due to the fact that it was believed that the plague would recede if it was passed on to someone else.

In the atmosphere of that time, any person who stood out from the crowd for any reason could be considered a poisoner.

Consequences of the Black Death

The Black Death had significant consequences in all areas of life. The most significant of them:

• The ratio of blood groups has changed significantly.
• Instability in the political sphere of life.
• Many villages were deserted.
• The beginning of feudal relations was laid. Many people in whose workshops their sons worked were forced to hire outside craftsmen.
• Since there were not enough male labor resources to work in the production sector, women began to master this type of activity.
• Medicine has moved to a new stage of development. All sorts of diseases began to be studied and cures for them were invented.
• Servants and the lower strata of the population, due to the lack of people, began to demand a better position for themselves. Many insolvent people turned out to be heirs of rich deceased relatives.
• Attempts were made to mechanize production.
• Housing and rental prices have dropped significantly.
• The self-awareness of the population, which did not want to blindly obey the government, grew at a tremendous pace. This resulted in various riots and revolutions.
• The influence of the church on the population has weakened significantly. People saw the helplessness of the priests in the fight against the plague and stopped trusting them. Rituals and beliefs that were previously prohibited by the church came into use again. The age of “witches” and “sorcerers” has begun. The number of priests has decreased significantly. People who were uneducated and inappropriate in age were often hired for such positions. Many did not understand why death takes not only criminals, but also good, kind people. In this regard, Europe doubted the power of God.
• After such a large-scale pandemic, the plague did not completely leave the population. Periodically, epidemics broke out in different cities, taking people’s lives with them.

Today, many researchers doubt that the second pandemic took place precisely in the form of the bubonic plague.

Opinions on the second pandemic

There are doubts that the "Black Death" is synonymous with the period of prosperity of the bubonic plague. There are explanations for this:

• Plague patients rarely experienced symptoms such as fever and sore throat. However, modern scholars note that there are many errors in the narratives of that time. Moreover, some works are fictional and contradict not only other stories, but also themselves.
• The third pandemic was able to kill only 3% of the population, while the Black Death wiped out at least a third of Europe. But there is an explanation for this too. During the second pandemic, there was terrible unsanitary conditions that caused more problems than illness.
• The buboes that arise when a person is affected are located under the armpits and in the neck area. It would be logical if they appeared on the legs, since that is where it is easiest for a flea to get into. However, this fact is not flawless. It turns out that, along with the plague, the human louse is also a spreader. And there were many such insects in the Middle Ages.
• An epidemic is usually preceded by the mass death of rats. This phenomenon was not observed in the Middle Ages. This fact can also be disputed given the presence of human lice.
• The flea, which is the carrier of the disease, feels best in warm and humid climates. The pandemic flourished even in the coldest winters.
• The speed of the epidemic's spread was record-breaking.

As a result of the research, it was found that the genome of modern strains of plague is identical to the disease of the Middle Ages, which proves that it was the bubonic form of pathology that became the “Black Death” for the people of that time. Therefore, any other opinions are automatically moved to the incorrect category. But a more detailed study of the issue is still ongoing.

The plague has deep historical roots. Humanity first encountered the disease in the 14th century. The epidemic, which was dubbed the “Black Death,” claimed more than 50 million human lives, which was equal to a quarter of the population of medieval Europe. The mortality rate was about 99%.

Facts about the disease:

• The plague affects the lymph nodes, lungs, and other internal organs. As a result of infection, sepsis develops. The general condition of the body is extremely difficult. The body is subjected to constant attacks of fever.
• The period of development of plague after infection is on average about three days, depending on the general condition of the body.
• At the moment, mortality from this disease is no more than 10% of all identified cases.
• There are about 2 thousand cases of the disease per year. According to WHO, in 2013, 783 cases of infection were officially registered, of which 126 cases resulted in death.
• Outbreaks of the disease mainly affect African countries and a number of countries in South America. Endemic countries are the Democratic Republic of Congo, the island of Madagascar and Peru.

In the Russian Federation, the last known case of plague was documented in 1979. Every year, more than 20 thousand people are at risk, being in the zone of natural foci of infection with a total area of ​​more than 250 thousand km2.

CAUSES

The main cause of plague is flea bites. This factor is due to the specific structure of the digestive system of these insects. After a flea bites an infected rodent, the plague bacterium settles in its crop and blocks the passage of blood to the stomach. As a result, the insect experiences a constant feeling of hunger and, before its death, manages to bite, thereby infecting up to 10 hosts, regurgitating the blood it drinks along with plague bacteria into the bite.

After a bite, the bacteria enters the nearest lymph node, where it actively multiplies and, without antibacterial treatment, affects the entire body.

Causes of infection:

• bites of small rodents;
• contact with infected domestic animals, stray dogs;
• direct contact with an infected person;
• cutting up carcasses of animals affected by disease;
• treatment of the skin of killed animals that carry the disease;
• contact of bacteria with the human mucosa during autopsy of corpses of those who died from the plague;
• eating meat from infected animals;
• entry of particles of saliva of an infected person into the oral cavity of a healthy person by airborne droplets;
• military conflicts and terrorist attacks using bacteriological weapons.

The plague bacterium is highly resistant to low temperatures, multiplies vigorously in a humid environment, but does not tolerate high temperatures (above 60 degrees), and dies almost instantly in boiling water.

CLASSIFICATION

Varieties of plague are divided into two main types.

• Localized type- the disease develops after plague microbes get under the skin:
  • Skin plague. There is no primary protective reaction, only in 3% of cases redness of the affected areas of the skin with induration occurs. Without visible external signs, the disease progresses, eventually forming a carbuncle, then an ulcer, which scars as it heals.
  • Bubonic plague . The most common form of the disease. It affects the lymph nodes, forming “buboes”. Characterized by painful inflammatory processes in them. Affects the groin area and armpits. Accompanied by severe fever and general intoxication of the body.
  • Bubonic skin plague. Plague bacteria travel along with the lymph, end up in the lymph nodes, causing an inflammatory process that affects neighboring tissues. The “buboes” mature, and the rate of development of the pathology decreases.
• Generalized type- the pathogen enters the body by airborne droplets, as well as through the membranes of the mucous surfaces of the body:
  • Septicemic plague. The pathogen penetrates through the mucous membranes. The high virulence of the microbe and a weakened body are the reasons for its easy entry into the patient’s blood, bypassing all his defense mechanisms. A fatal outcome with this form of the disease can occur in less than 24 hours, the so-called. "lightning plague"
  • Pneumonic plague. Entry into the body occurs through airborne droplets, infection through dirty hands and objects, as well as through the conjunctiva of the eyes. This form is primary pneumonia, and also has a high epidemic threshold due to the abundant secretion of sputum containing pathogenic bacteria during coughing.

SYMPTOMS

The incubation period of the plague ranges from 72 to 150 hours. Most often it appears on the third day. The disease is characterized sudden manifestation without primary symptoms.

Clinical history of plague:

• a sharp jump in body temperature up to 40 degrees;
• acute headaches;
• nausea;
• reddish tint to the face and eyeballs;
• muscle discomfort;
• white coating on the tongue;
• enlarged nostrils;
• dry skin of lips;
• manifestations of a rash on the body;
• feeling of thirst;
• insomnia;
• causeless excitement;
• difficulties in coordinating movements;
• delusions (often of an erotic nature);
• impaired digestion;
• difficulty urinating;
• high fever;
• cough with sputum containing blood clots;
• bleeding from the gastrointestinal tract;
• tachycardia;
• low blood pressure.

Hidden primary symptoms lead to outbreaks of disease epidemics. Thus, a potential carrier of plague can travel long distances, feeling absolutely healthy, while infecting everyone who comes into contact with the plague bacteria.

DIAGNOSTICS

Returning from travel to areas endemic for the spread of plague, with the slightest signs of the disease - urgent reason to isolate the patient. Based on the medical history, all persons who have had any contact with the potentially affected person are identified.

Diagnostics is carried out in the following ways:

• bacterial culture from blood, sputum and lymph node tissue samples;
• immunological diagnostics;
• polymerase chain reaction;
• passage on laboratory animals;
• serological technique;
• isolation of pure culture followed by identification;
• laboratory diagnostics based on fluorescent antiserum.

In today's medical environment, direct transmission from the patient to the attending physician and hospital staff is virtually impossible. However, everything laboratory tests are carried out in specialized premises for working with particularly dangerous infectious diseases.

TREATMENT

Since 1947 plague treatable with antibiotics group of aminoglycosides with a broad spectrum of action.

Inpatient treatment is used in isolated wards of infectious diseases departments in compliance with all safety rules when working with plague patients.

Course of therapy:

• The use of antibacterial drugs based on sulfamethoxazole and trimethoprim.
• Intravenous administration of chloramphenicol simultaneously with streptomycin.
• Detoxification procedures.
• Improving microcirculation and repair. Achieved by entering .
• Taking cardiac glycosides.
• Use of respiratory analeptics.
• Use of antipyretics.

Treatment is most effective and does not cause any consequences in the initial stages of plague.

COMPLICATIONS

Because the disease is included in the group of fatal, the main complications in case of an incorrect diagnosis or lack of proper treatment may be the transformation of the plague from a mild form to more severe ones. Thus, cutaneous plague can develop into septicemic plague, and bubonic plague into pneumonic plague.

Complications from plague also affect:

• Cardiovascular system (pericarditis develops).
• Central nervous system (purulent meningoencephalitis).

Although a patient who has recovered from the plague receives immunity, he is not completely immune from new cases of infection, especially if preventive measures are taken carelessly.

PREVENTION

At the state level, a whole range of directive preventive measures for the plague has been developed.

The following decrees and rules are in effect on the territory of the Russian Federation:

• “Instructional and methodological guidelines for the diagnosis, treatment and prevention of plague”, approved by the USSR Ministry of Health on September 14, 1976.
• Sanitary and epidemiological rules SP 3.1.7.1380-03 dated 06.06.2003, approved by the Resolution of the Chief State Sanitary Doctor in the part “Prevention of plague”.

Set of measures:

• epidemiological surveillance of natural foci of disease;
• disinsection, reducing the number of potential disease carriers;
• a set of quarantine measures;
• training and preparing the population to respond to outbreaks of plague;
• careful handling of animal corpses;
• vaccination of medical staff;
• use of anti-plague suits.

PROGNOSIS FOR RECOVERY

The mortality rate from plague at the present stage of therapy is about 10%. If treatment is started at a later stage or is absent altogether, the risks increase to 30-40%.

With the right choice of treatment methods the body recovers in a short time, performance is fully restored.

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What is the plague and why is it called the Black Death?

Plague is a serious infectious disease that leads to large-scale epidemics and often ends in the death of the sick person. It is caused by Iersinia pestis, a bacterium that was discovered at the end of the 19th century by the French scientist A. Yersin and the Japanese researcher S. Kitazato. At the moment, the causative agents of plague have been studied quite well. In developed countries, plague outbreaks are extremely rare, but this was not always the case. The first plague epidemic described in the sources occurred in the 6th century on the territory of the Roman Empire. Then the disease claimed the lives of about 100 million people. 8 centuries later, the history of the plague repeated itself in Western Europe and the Mediterranean, where more than 60 million people died. The third large-scale epidemic began in Hong Kong at the end of the 19th century and quickly spread to more than 100 port cities in the Asian region. In India alone, the plague led to the death of 12 million people. Due to its severe consequences and characteristic symptoms, the plague is often called the “Black Death”. It really does not spare either adults or children and, in the absence of treatment, “kills” more than 70% of infected people.

Nowadays, the plague is rare. However, there are still natural foci around the globe where infectious agents are regularly detected in rodents living there. The latter, by the way, are the main carriers of the disease. Deadly plague bacteria enter the human body through fleas, which are looking for new hosts after the mass death of infected rats and mice. In addition, the airborne route of transmission of infection is known, which, in fact, determines the rapid spread of plague and the development of epidemics.

In our country, plague-endemic regions include the Stavropol region, Transbaikalia, Altai, the Caspian lowland and the Eastern Ural region.

Etiology and pathogenesis

Plague pathogens are resistant to low temperatures. They are well preserved in sputum and are easily transmitted from person to person by airborne droplets. When a flea bites, a small papule filled with hemorrhagic contents (skin plague) first appears on the affected area of ​​skin. After this, the process quickly spreads through the lymphatic vessels. They create ideal conditions for the proliferation of bacteria, which leads to the explosive growth of plague pathogens, their fusion and the formation of conglomerates (bubonic plague). Bacteria may enter the respiratory system with further development of the pulmonary form. The latter is extremely dangerous, as it is characterized by a very fast current and covers vast territories due to intensive spread between members of the population. If treatment for plague begins too late, the disease turns into a septic form, which affects absolutely all organs and systems of the body, and in most cases ends in the death of a person.

Plague - symptoms of the disease

Symptoms of the plague appear after 2 to 5 days. The disease begins acutely with chills, a sharp increase in body temperature to critical levels, and a drop in blood pressure. These signs are subsequently joined by neurological symptoms: delirium, loss of coordination, and confusion. Other characteristic manifestations of the Black Death depend on the specific form of infection.

• bubonic plague - enlarged lymph nodes, liver, spleen. Lymph nodes become hard and extremely painful, filled with pus, which eventually breaks out. Incorrect diagnosis or inadequate treatment of plague leads to the death of the patient 3-5 days after infection;
• pneumonic plague - affects the lungs, patients complain of coughing, copious discharge of sputum, which contains blood clots. If treatment is not started in the first hours after infection, then all further measures will be ineffective and the patient will die within 48 hours;
• septic plague - symptoms indicate the spread of pathogens throughout literally all organs and systems. A person dies within a day at most.

Doctors also know the so-called minor form of the disease. It is manifested by a slight rise in body temperature, swollen lymph nodes and headache, but usually these symptoms disappear on their own after a few days.

Treatment of plague

Diagnosis of plague is based on laboratory culture, immunological methods and polymerase chain reaction. If a patient is diagnosed with bubonic plague or any other form of this infection, he is immediately hospitalized. When treating plague in such patients, medical facility personnel must take strict precautions. Doctors should wear 3-layer gauze bandages, protective glasses to prevent sputum from getting on the face, shoe covers and a cap that completely covers the hair. If possible, special anti-plague suits are used. The compartment in which the patient is located is isolated from other premises of the institution.

If a person is diagnosed with bubonic plague, he is administered streptomycin intramuscularly 3-4 times a day and tetracycline antibiotics intravenously. In case of intoxication, patients are advised to use saline solutions and hemodez. A decrease in blood pressure is considered as a reason for emergency treatment and resuscitation measures in the event of an increase in the intensity of the process. Pneumonic and septic forms of plague require increasing doses of antibiotics, immediate relief of intravascular coagulation syndrome, and administration of fresh blood plasma.

Thanks to the development of modern medicine, large-scale plague epidemics have become very rare, and currently the mortality rate of patients does not exceed 5-10%. This is true for cases where treatment of the plague begins on time and complies with established rules and regulations. For this reason, if there is any suspicion of the presence of plague pathogens in the body, doctors are obliged to urgently hospitalize the patient and alert the authorities involved in controlling the spread of infectious diseases.

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Plague is a deadly disease caused by the plague bacillus (bacterium Yersinia Pestis). It can be transmitted to humans through rodents, fleas, poorly prepared food, and even through inhaled air. Improvements in sanitation and living standards have made outbreaks of plague extremely rare, although they still occur in some regions of the globe. Protect yourself and your loved ones from potential exposure to the plague: avoid contact with animals that carry it, strictly follow sanitary and hygiene rules, and seek immediate medical attention if you suspect that you may have been infected with the disease.

Steps

Part 1

Eliminate rodent-friendly habitats around your home. The plague spreads among rats, which become infected through the bites of fleas that use these rodents as hosts. Eliminate possible rat habitats in and around your home. Check for signs of rats in utility rooms, dense bushes, basements, garages and attics.

• The presence of rats can be determined by the excrement they leave behind. If you find rat droppings, remove them immediately. Be careful as the plague bacillus can survive and be transmitted to you by touching contaminated feces.
• Before cleaning up rat droppings, be sure to wear gloves and cover your mouth and nose (such as with gauze or a handkerchief) to avoid contact with pathogenic bacteria.

1. Do not touch sick or dead animals. After the death of an animal, an active plague bacillus may remain in its tissues or in the fleas living on it. Stay away from sick or dead animals that show signs of distemper. Plague can be transmitted to a living host through infected tissues and fluids.

   Use flea repellent whenever you go outside. Apply diethyltoluamide spray or ointment if you plan to be outside for a long time. Plague is often spread through the bites of fleas, which live in the fur of rodents and feed on infected blood. Diethyltoluamide and other repellents will repel fleas and help prevent infestation.

   Wash regularly and thoroughly. Wash your hands and face with water and disinfectant soap several times throughout the day, and also every time after returning from the street or contact with animals or their droppings. The plague bacillus can enter the body through the delicate tissues of the mouth, nose and eyes. Practice basic hygiene carefully and be aware of the risk factors around you.

   • Try to touch your face with your hands as little as possible. The disease easily penetrates sensitive tissue, and you never know if you have recently touched something that might have pathogenic bacteria on it.

2. Be aware of the symptoms of the plague. Plague may not cause any symptoms for several days. Within a week, the patient begins to experience flu-like symptoms, including chills, fever, cold sweats, nausea and vomiting. As the disease progresses, the lymph nodes become swollen and tender as the body fights the infection. In the later stages, the plague is accompanied by sepsis, that is, blood poisoning, and decomposition of body tissues. Eventually death comes.