“How many valiant men, how many fair ladies breakfasted with their kingfolk and that same night supped with their ancestory in the other world”
Definition
A disease of rats and other small vertebrates caused by pasturella pestis, and communicated to humans by rat, occasionally of infected tissues and manifesting in bubonic,pneumonic and septicaemic forms.A dread disease that has probably caused more human deaths than all other disease and warfare combined.Mainfests in three varieties-after usual incubation period of 2-8 days. Fever, chills, muscular pains and extreme prostration at onset Bubonic (painful and very tender axillary and inguinal lymph gland enlargement with overlying skin lesion, pustule at site of bite might progress to septicaemic or pneumonic type. Pneumonic within a day of airborne exposure with cough,chest pain, haemoptysis, dyspnea hypotension, and Septicaemic buboes, hypotension, hepatosplenomegly, derlium, and purpuric spots appearing on the skin (‘black plague’)Diagnosis by gram stain of aspirate from buno, sputum, and blood (gram negative coccobacilli with ‘safety pin appearance), and culture which takes some days., Leucoytosis with neutrophil predominance.
Prognosis
Untreated plague carries a mortality of >50%, and pneumonic carries a 100%mortality and the patient will die within a day if treatment is delayed .Prompot treatment leads to quick cure.s
General Measures
If post-tussive vomiting is severe food may be given after vomiting ceasesGood nursing care nutrition, hydration and quarantine for 4 weeks, and for 1 week after erythromycin is started.Parental fluids and nasal oxygen if indicated.Avoid triggers that precipitate paroxysms. in infants..
Follow Up
Life long for medication, assessment of progress, and physiothereapy.
Inadequate Response
Small children might need hospital care.
Prevention
Active immunization for all infants usually combined with diphtheria and tetanus (DPT). Booster dose recommended after the age of 6 years.Erthromycin prophylaxis to exposed children unprotected by vaccination..
