Infectious Diseases and Microbiology - Plague ( Yersinia pestis)
Plague due to Yersinia pestis Gram-negative, nonmotile rod that, when stained with specific dyes, displays bipolar staining. The two ways that the plague is spread are by respiratory aerosols or by the bites of infected fleas from rats (urban plague) or wild animals (sylavatic plague). In the US, endemic regions are concentrated in the western states (AZ, NM, CO, CA). Three main types: High fever and massive, enlarged inguinal, axillary, or cervical lymph nodes—known as "bubbos"—are the hallmarks of the bubonic plague. A bacteremic phase with an abrupt onset of fever and chills may ensue from progression. Inhaling infectious aerosols or lung embolization of bacterium-causing organisms cause pneumonic plague. Disease development is fast and highly deadly. The effects of endotoxins, such as disseminated intravascular coagulation and peripheral blood vessel necrosis, cause septicemic plague, sometimes known as the "black death." A protein capsule, endotoxin, plasminogen activator protease, and a group of YOPS proteins are examples of virulence factors. These proteins interfere with host cell signaling and alter the host cell cytoskeleton. Proteins are directly injected into the host cell's cytoplasm by type III secretion systems. Survival and replication inside macrophages promote enormous inflammatory lymph node enlargement. Human spread is facilitated by plasminogen-activating protease, but flea proventriculus blocking by coagulase improves flea transmission. Notifying the laboratory should happen if plague is suspected. Detailed inspection following staining and culturing from Sputum, diagnosis blood, or buboe aspirate are diagnostic tools. The preferred antibiotic is streptomycin. Other options include gentamicin, tetracycline, or chloramphenicol. In Y pestis, drug resistance has been observed. Controlling rat populations in urban areas and avoiding touching dead animals in endemic areas are two aspects of prevention. For those at high risk, there is a whole-cell vaccine that has been inactivated.
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