Mongolia and China have recorded outbreaks of bubonic plague, a dangerous disease that has claimed millions of lives in the past. So far, only three people have been infected, but the authorities are taking all necessary measures to contain a potential epidemic. In the mass consciousness, the plague is associated with the deadly "black death" that terrorized medieval Europe.
Shadow of greatness
Although often referred to as a disease of the past, the plague continues to exist and pose a threat to certain populations, such as people in Africa. Doctors classify it as a re-emerging disease, that is, it is characterized by the re-emergence of active foci and spread over the territories where it was already present. As a rule, plague is limited to the area of distribution of the pathogen.
Plague stick.
Africans are at great risk as they have to live side by side with rodents, and widespread poverty, coupled with superstition, prevent them from receiving qualified medical care. However, the disease, as in the past, can spread over long distances in a short time due to the fact that rodents with fleas can climb into bags and containers.
The development of medicine, hygiene rules and the emergence of antibiotics drove the "black death" to the outskirts of civilization, and new outbreaks are quite ordinary cases that occur year after year and are successfully contained by doctors.
In the second half of the 20th century, outbreaks of plague decreased significantly, although foci of the disease still remain in developing countries. During this period, the plague was registered in about forty countries, while, according to the WHO, from 1987 to 2001, the dangerous bacterium infected about 40 thousand people, of whom about three thousand died. From 2010 to 2015, 3248 cases of infection were reported, with 584 deaths.
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In most cases, flea-borne disease passed in bubonic form, but in some cases, a more dangerous pulmonary form developed. About half of the cases occur in people aged 12-45, and men are more likely to become infected than women. The incubation period of the disease is from one day to a week, and mortality in the absence of treatment reaches 30-60 percent in the bubonic form and one hundred percent in the pulmonary form.
The abode of the "black death"
Less than 200 people die from the plague every year, which is orders of magnitude less than from the flu. In addition, most often death occurs due to lack of treatment. The outbreaks themselves are limited to a certain area - these are regions of Africa far from civilization, some countries of Central and South America, as well as India and Mongolia. The most epidemiologically unfavorable territories are in the Democratic Republic of the Congo, Madagascar and Peru. In Madagascar, outbreaks of bubonic plague occur every year, from September to April.
In 2017, a fairly large outbreak of plague occurred on the island, while the disease got out of the endemic areas where infectious agents usually live. From August to October alone, about two thousand people were infected and more than two hundred died. The dominant form was the extremely dangerous pulmonary form of the disease. Through the efforts of the WHO and other international health organizations, it was possible to prevent the plague from spreading to other countries. Doctors closely monitored the health of those in contact with sick people, conducted preventive courses of antibiotics and intensified screening of potentially sick people at the country's international airports.
Sometimes, however, the plague also affects Western countries. In the United States, the plague bacillus infects 5 to 15 people annually, with the majority of deaths occurring in New Mexico, a state known for its desert and arid climate. Natural reservoirs of the pathogen in the United States are prairie dogs and rocky ground squirrels. Fleas that live on wild animals can jump onto pets, increasing the risk of human infection.
Natural foci of outbreaks of plague.
In Russia, the unfavorable regions are the territories of the Altai Republic, the Astrakhan region, as well as those that border on Kazakhstan, Mongolia and China. About 20 thousand people living near natural foci of the disease are at high risk of infection.
The plague won't pass
A vaccine against the plague, which creates temporary immunity, exists, however, due to rare outbreaks, it is usually carried out only by scientists and doctors who work with Yersinia pestis and who are in direct contact with its vectors; and those who live in areas of natural habitat of sources of the causative agent. For vaccination, dead bacteria were originally used, but live and protein vaccines are used against pneumonic plague. If a person is already sick, then antibiotics remain the main method of treatment - streptomycin, tetracycline and others.
There are several factors holding back a pandemic in today's world. The main thing can be considered a high level of hygiene, when the possibility of contact with carriers of the pathogen is minimized. That is why outbreaks occur in remote regions, and cases of plague in cities are quite rare. However, the infection practically does not spread to other people. The only exception is the pulmonary form, which is transmitted by airborne droplets.
Lungs afflicted with a plague stick.
Timely antibiotic treatment is another factor. Finally, for an epidemic to occur, it takes a large number of flea-carrying rodents to become infected with the plague bacillus. Then unsanitary conditions will play a role, facilitating contact of insects with people. If an outbreak occurs, then the systematic extermination of rodents remains an effective containment method.
Doctors usually recommend refraining from traveling to countries with an unfavorable epidemiological situation, since travelers are usually not given vaccinations against plague. However, severe and rapidly developing symptoms make it possible to quickly identify patients without spreading the infection across country borders. Therefore, it is extremely unlikely that people infected with the bubonic plague who have come from abroad can cause an epidemic in Russia, as happened with the coronavirus infection, which is always transmitted by airborne droplets.
However, it is worth noting that, as with other bacterial infections, there is a risk of developing antibiotic resistance when drug-resistant strains emerge. The first case of Yersinia pestis antibiotic resistance was recorded in Madagascar in 1995. But such strains are hardly more dangerous than the more common Staphylococcus aureus and Klebsiella pneumoniae, which are viewed as a real threat to international health.