Plague

Plague has three distinct clinical forms. Bubonic plague may resemble many viral syndromes; a distinct feature is buboes. Buboes are swollen lymph nodes filled with multiplying bacteria. They form near the bacteria’s entry point into the bloodstream. Septicemic plague symptoms can include abdominal pain and shock, with bleeding into skin and internal organs. Tissue manifestations include fingers, toes, or other areas turning black and necrotic. Bubonic and septicemic forms are transmitted by flea bites or the handling of infected animals. Pneumonic plague is easily transmitted from human to human by the inhalation of infectious droplets. Pneumonic plague is often lethal, resulting in respiratory failure and shock. Antibiotic treatment should be started as soon as plague as suspected. A vaccine, which is no longer being manufactured, was effective against the bubonic plague but not pneumonic plague. Research is ongoing for a vaccine effective against pneumonic plague, the form most likely to be utilized as a biological weapon.