Summary
Plague is a severe bacterial infection that is extremely rare in Europe but still spreads in Africa and, to a lesser degree, in Asia and Latin America. It is caused by the Gram-negative bacterium Yersinia pestis. It is transmitted from animals to humans by fleas. Rodents form the reservoir for the disease. Plague is also transmitted between humans via the respiratory route. There are two clinical forms of the disease: bubonic plague, characterized by painfully inflamed lymph nodes called ``buboes'', an elevated temperature and an altered clinical state; and pulmonary plague which manifests itself as thoracic pain, a cough with bloody expectoration, an elevated temperature, an altered clinical state and consciousness disorders. Diagnosis is based on isolation of the bacterium in the bubo, blood or expectoration, or from serology. Many classes of antibiotics are effective against Yersinia pestis (aminoglycosides, tetracyclines, cotrimoxazole, rifampicine, fluoroquinolones...). Without treatment, the course of the disease is rapidly fatal. *Author : Dr F. Rachillas (November 2009)*.
