Materiały źródłowe

• #1 Plague Prevention and Therapy: Perspectives on Current and Future Strategies

  https://www.mdpi.com/2227-9059/9/10/1421

  Plague, caused by the bacterial pathogen Yersinia pestis, is a vector-borne disease that has caused millions of human deaths over several centuries. […] Here, we review research advances in the areas of vaccines and therapeutics for plague in context of Y. pestis virulence factors and disease pathogenesis. Plague continues to be both a public health threat and a biodefense concern and we highlight research that is important for infection mitigation and disease treatment. […] Control and prevention of plague cases in Madagascar has proven to be challenging. Most of the prevention strategies are focused on the rodent host and the flea vectors. […] Importantly, distribution of supplies and equipment including hand washing facilities, sanitation standards, disinfectants (e.g., laundry soap, chlorine powder, disinfectant sprays), and personal protective equipment contribute to an efficient plague prevention strategy.

• #2 Plague Prevention and Therapy: Perspectives on Current and Future Strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533540/

  Plague continues to be both a public health threat and a biodefense concern and we highlight research that is important for infection mitigation and disease treatment. […] Control and prevention of plague cases in Madagascar has proven to be challenging. Most of the prevention strategies are focused on the rodent host and the flea vectors. […] Importantly, distribution of supplies and equipment including hand washing facilities, sanitation standards, disinfectants (e.g., laundry soap, chlorine powder, disinfectant sprays), and personal protective equipment contribute to an efficient plague prevention strategy. […] If diagnosed accurately and early after infection, human plague cases can be controlled by the appropriate administration of antimicrobial drugs, including aminoglycoside, tetracyclines, fluroquinolones, and sulfonamides.

• #3 Preventing Plague | Plague | CDC

  https://www.cdc.gov/plague/prevention/index.html

  People who live in areas where plague occurs can take several steps to reduce their risk of becoming infected. […] Reduce rodent habitat around your home, workplace, and recreational areas. Remove brush, rock piles, junk, cluttered firewood, and possible rodent food supplies, such as pet and wild animal food. Make your home and outbuildings rodent-proof. […] Wear gloves if you are handling or skinning potentially infected animals to prevent contact between your skin and the plague bacteria. […] Use repellent if you think you could be exposed to fleas during activities such as camping, hiking, or working outdoors. Products containing DEET can be applied to the skin as well as clothing and products containing permethrin can be applied to clothing (always follow instructions on the label).

• #4 Bubonic Plague (Black Death): What Is It, Symptoms, Treatment

  https://my.clevelandclinic.org/health/diseases/21590-bubonic-plague

  Prevention involves reducing your exposure to mice, rats, squirrels and other animals that may be infected. […] You can take the following steps to prevent bubonic plague: […] Make your home and yard inhospitable to rodents (mice, rats, squirrels) and other wild animals. Don’t leave places for them to hide or food for them to eat. This means cleaning up clutter, brush and other items and being careful when feeding animals. […] Use flea control products for your pets, especially those who are allowed to roam freely. Take sick pets to the veterinarian immediately. […] Don’t let pets who roam freely sleep in your bed. […] Wear protective clothing especially gloves if you handle dead animals. […] Use insect repellent if you go into wooded locations or other places that may expose you to fleas. Look for repellents that use DEET or permethrin. […] The best way to prevent getting plague is to avoid the fleas that live on rodents such as rats, mice and squirrels. The fleas can also live on chipmunks and rabbits. Take care to protect your pets and yourself from fleas and the possible infections they can carry.

• #5 Plague – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plague/symptoms-causes/syc-20351291

  No vaccine is available, but scientists are working to develop one. Antibiotics can help prevent infection if you were likely exposed to plague. […] People with pneumonic plague are isolated during treatment to prevent the spread of disease. Health care workers must wear protective masks, gowns, gloves and eyewear when they treat someone with pneumonic plague. […] If you live or spend time outdoors where plague occurs: […] Rodent-proof your home. Remove nesting areas for rodents, such as piles of brush, rock, firewood and junk. Don’t leave pet food in areas that rodents can easily access. If you become aware of rodents living in your home, take steps to remove them. […] Protect your pets. Use flea-control medicines for your pets. Talk to your vet about the best options. If your pet is sick, get prompt treatment. Don’t let pets sleep with you if they are outside in areas where plague occurs.

• #5 Plague – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plague/symptoms-causes/syc-20351291

  Protection from animals. When handling dead animals, wear gloves to prevent contact between your skin and the animal. Call your local health department if you have concerns about the removal of a dead animal. […] Use insect repellent on skin and clothing. When outdoors, use insect repellents registered with the U.S. Environmental Protection Agency. These include products that contain DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-3,8-diol or 2-undecanone. Do not use a spray directly on your face. Do not use products with OLE or PMD on children under age 3. Do not use insect repellent on a child under 2 months old.

• #6 Plague: Types, History, Causes & Prevention

  https://my.clevelandclinic.org/health/diseases/17782-plague

  You can reduce your risk of plague by avoiding flea bites and being careful around animals that could be infected. […] Clear piles of brush, wood, trash or other places where wild animals might make a home. Don’t leave pet food out or feed wild animals. […] Wear bug spray with DEET. […] Ask your pet’s veterinarian how to prevent fleas. Pet dogs and cats can spread plague. […] Wear gloves if you have to handle animals that could be infected. This includes living and dead animals. […] If you live in an area with plague, don’t let your pets roam free outside. […] If you think something exposed you to plague, ask your healthcare provider whether you should take antibiotics to prevent getting sick. […] Vaccines aren’t widely used to protect against plague. Scientists are currently working on creating more effective plague vaccines.

• #7 Plague Follow-up: Transfer, Deterrence/Prevention, Complications

  https://emedicine.medscape.com/article/235627-followup

  To be effective, chemoprophylaxis must be initiated within 7 days of exposure. […] The vaccine is not effective against the pneumonic form of plague. Plague vaccine is recommended for field workers in endemic areas and for scientists and laboratory personnel who routinely work with the plague bacterium. […] Efforts to control the animal reservoir and flea population may be effective in reducing transmission of plague bacteria. Remove food sources used by rodents. Rodent-proof homes, buildings, and warehouses. […] Trained professionals should apply chemicals to kill fleas and rodents. Trained professionals should fumigate cargo areas of ships and docks. […] Personal protective measures include wearing protective clothing and applying insect repellents to clothing and skin to prevent flea bites.

• #7 Plague Follow-up: Transfer, Deterrence/Prevention, Complications

  https://emedicine.medscape.com/article/235627-followup

  Patients with plague who are critically ill and require transfer to another facility should be transported under strict isolation precautions. […] The CDC recommends short-term prophylactic antibiotic therapy in people who have been bitten by potentially infected rodent fleas during a plague outbreak. Prophylactic antibiotic therapy is recommended in persons who have handled an animal known to be infected with the plague bacterium. […] Prophylactic antibiotic therapy is recommended in persons who have had close exposure to a person or an animal thought to have pneumonic plague. Sulfadoxine prophylaxis has been effective in outbreaks of pneumonic plague. […] Preferred antibiotics for prophylaxis against plague include doxycycline 100 mg PO q12h for 14-21 days (for patients 8 y) or full-dose ciprofloxacin for 7 days.

• #8

  https://www.who.int/news-room/fact-sheets/detail/plague

  Surveillance and control requires investigating animal and flea species implicated in the plague cycle in the region and developing environmental management programmes to understand the natural zoonosis of the disease cycle and to limit spread. Active long-term surveillance of animal foci, coupled with a rapid response during animal outbreaks has successfully reduced numbers of human plague outbreaks. […] WHO aims to prevent plague outbreaks by maintaining surveillance and supporting at-risk countries to prepare.

• #8

  https://www.who.int/news-room/fact-sheets/detail/plague

  Antibiotic treatment is effective against plague bacteria, so early diagnosis and early treatment can save lives. […] Preventive measures include informing people when zoonotic plague is present in their environment and advising them to take precautions against flea bites and not to handle animal carcasses. Generally people should be advised to avoid direct contact with infected body fluids and tissues. When handling potentially infected patients and collecting specimens, standard precautions should apply. […] Protect health workers. Inform and train them on infection prevention and control. Workers in direct contact with pneumonic plague patients must wear standard precautions and receive a chemoprophylaxis with antibiotics for the duration of seven days or at least as long as they are exposed to infected patients.

• #9 Plague – Ventura County Resource Management Agency

  https://rma.venturacounty.gov/divisions/environmental-health/plague/

  Plague is successfully treated with antibiotics in the early stages, but correct early diagnosis is essential. Plague can quickly progress to the more serious stages (septicemic and pneumonic plague). […] Because of the potential danger of pneumonic plague epidemics, Environmental Health staff place a high priority on prevention of human plague cases. You can minimize your exposure to plague by carefully following the precautions listed below. […] Preventive measures will be instituted when animal plague is found in areas where human exposure is possible. Warning signs will be posted, and after careful evaluation, the area may be quarantined. […] Insecticide dust is applied into rodent burrows or into bait stations (tube-like containers). Rodents that enter the bait station pick up the insecticide dust in their fur, killing the fleas. The dust is also taken back to the nest in their fur, killing the fleas in the nest. This method of flea control is very effective. It minimizes the amount of insecticide used and does not harm the rodents.

• #10 Plague: symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/plague

  Early administration of tetracyclines, sulfonamides or fluoroquinolones is generally a highly effective preventive treatment strategy in close contacts of plague sufferers. […] Travelers to endemic foci are advised to avoid contact with rodents and to protect themselves from flea bites with skin repellents effective in these endemic areas. […] In the event of contact with a plague patient with a cough, advice should be immediately sought from a doctor who can prescribe antibiotics as a preventive measure. […] Prevention by vaccination was discontinued as the first vaccines caused side effects that were sometimes severe. […] Other vaccines were subsequently developed but they are not effective for pneumonic plague. […] Several vaccines are currently in the research stages but they are yet to be validated in humans.

• #11 Plague: Types, Symptoms, Causes, Prevention and Treatments

  https://www.acko.com/health-insurance/diseases/plague/

  How can I prevent the Plague? […] As of today, there are no vaccines for the deadly Plague disease. But you can still prevent getting exposed to it by taking the following steps. […] Avoid travelling in areas endemic to Plague. […] Keep your home, office, and other recreational areas rodent-free by filling up the holes and gaps. […] Use flea control products that contain DEET to protect your pets from fleas. […] When possible, wear closed-toed shoes and tuck trousers into socks. […] Do not let your pets wander freely or sleep on your bed. […] If you’re in high-risk areas of the Plague, avoid handling animals (dead or alive). […] Get your pet to the veterinarian immediately if it feels ill. […] Wear insect repellent while outdoors. […] Wear gloves and masks to avoid contact with people suspected of having the Plague. […] Seek medical help and follow instructions if you think you have been exposed to infected rodents or fleas.

• #12 Preventing Plague | Plague | CDC

  https://www.cdc.gov/plague/prevention/index.html

  Keep fleas off of your pets by applying flea control products. Animals that roam freely are more likely to come in contact with plague infected animals or fleas and could bring them into homes. If your pet becomes sick, seek care from a veterinarian as soon as possible. […] Do not allow dogs or cats that roam free in endemic areas to sleep on your bed. […] A plague vaccine is no longer available in the United States. New plague vaccines are in development but are not expected to be commercially available in the immediate future.

• #13 Plague Symptoms, Treatment, and Infection Prevention | NETEC

  https://netec.org/2022/08/08/plague-symptoms-treatment-and-infection-prevention/

  Prompt treatment is critical to prevent complications or death. […] Two classes of antibiotics are recommended for the initial treatment for Y. pestis infection, at least one of which is considered first-line. […] The use of two antibiotics is recommended to minimize the chance that the patient receives ineffective therapy. […] Antibiotics can be offered as post-exposure prophylaxis to individuals who were not wearing a mask and had close prolonged contact with a patient with pneumonic plague. […] Antibiotics are generally given for 7 days in the event of exposure.

• #14 Plague (disease) – Wikipedia

  https://en.wikipedia.org/wiki/Plague_(disease)

  Prevention Plague vaccine. […] Those at high risk may be vaccinated. […] Those exposed to a case of pneumonic plague may be treated with preventive medication. […] Pre-exposure prophylaxis for first responders and health care providers who will care for patients with pneumonic plague is not considered necessary as long as standard and droplet precautions can be maintained. […] Postexposure prophylaxis should be considered for people who had close (6 feet), sustained contact with a patient with pneumonic plague and were not wearing adequate personal protective equipment. […] Specific recommendations on pre- and post-exposure prophylaxis are available in the clinical guidelines on treatment and prophylaxis of plague published in 2021.

• #15 Plague | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617121/all/Plague?q=chloramphenicol

  Plague is an enzootic disease transmitted by fleas from wild rodents and caused by Yersinia pestis. […] Reduce rodent shelter and food sources in the immediate vicinity of the home by storing grain and animal food in rodent-proof containers. […] Flea disinfestation of cats and dogs, especially in endemic areas. […] Avoid direct contact with ill or dead animals and never feed squirrels, chipmunks, or other wild rodents. […] All persons with exposure to a known or suspected plague source in the previous 6 days should be offered prophylaxis or be told to report illness or fever 38.3 C to their physician. […] Persons with close (2 m) contact with a patient with pneumonic plague should receive antimicrobial prophylaxis, but isolation is not necessary. […] Doxycycline (PO), OR […] Ciprofloxacin (PO) at treatment doses for 7 days from last exposure. […] Notify state public health authorities of cases of suspected and proven Y. pestis infection. […] A vaccine for plague is no longer available.

• #16 Plague Prevention and Therapy: Perspectives on Current and Future Strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8533540/

  Individuals in close contact with people afflicted with pneumonic plague, exposed to Y. pestis infected fleas, or who have been handling body fluids or tissues infected with Y. pestis should receive prophylactic antibiotic therapy. […] The emergence of multidrug-resistant (MDR) strains of bacterial pathogens, including Y. pestis, is one of the most critical issues facing public health due to the difficulty in treatment, the high cost associated with medical care (particularly in developing countries) and increased mortality rates associated with the drug-resistant phenotypes. […] An effective and safe plague vaccine is important from a public health perspective but also in context of national biodefense strategies. […] Due to the relative ease of transmissibility, rapid course of disease, non-descript clinical signs and symptoms, high mortality, and antibiotic resistance potential, effective vaccine strategies are needed.

• #17 Plague | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/plague-16689935.html

  Plague is transmitted to man by infected animals (direct contact or inhalation of their respiratory secretions), the bite of a flea of infected animals, or inhalation of respiratory secretions of individuals with pneumonic plague. […] Start empiric antibiotic treatment for 10 to 14 days as soon as plague is suspected, before results of diagnosis tests are available. […] Follow national recommendations according to antibiotic resistance patterns if known. […] In the event of contact (distance less than 2 meters without appropriate personal protective equipment) with a pneumonic plague patient or direct contact with infected body fluids or tissues of any plague patient and within one week after the end of exposure: doxycycline PO for 7 days Children: 2.2 mg/kg (max. 100 mg) 2 times daily Adults (including pregnant women): 100 mg 2 times daily or ciprofloxacin PO for 7 days Children: 20 mg/kg (max. 750 mg) 2 times daily Adults: 500 to 750 mg 2 times daily. […] Flea vector control, sanitation and rodent reservoir control, refer to the guide Public health engineering, MSF. […] Vaccination against plague is indicated for laboratory technicians handling rodents or working with Y. pestis and is not a method for controlling an epidemic.

• #18 Factsheet about plague

  https://www.ecdc.europa.eu/en/plague/facts

  Plague can be avoided by reducing contact with wild rodents and their fleas, either through personal protection or by environmental sanitation including rodent and flea control. In natural foci, monitoring programmes should be set up so that control can be promptly initiated. Medical staff should wear gloves and masks when nursing plague patients. There is no approved vaccine but antibiotics can be used as prophylaxis. […] In case of a large outbreak, mass distribution of ciprofloxacin has been suggested.

• #19 Controlling Spread of Plague | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/plague/controlling

  Droplet Precautions are indicated when caring for patients with plague until pneumonia is excluded and appropriate antibiotic therapy has been initiated. […] Cases with pneumonic plague are considered infectious throughout their symptomatic illness and for 72 hours following initiation of antibiotic treatment. People who have been in household or face-to-face contact with a case with pneumonic plague during the infectious period should be educated regarding signs and symptoms and recommended prophylaxis, and referred to their healthcare provider for antibiotic prophylaxis. […] If contacts of a pneumonic plague case are unable to receive antibiotic prophylaxis, they should be placed under a strict quarantine for a 7-day period. […] To avoid plague, people should reduce the likelihood of being bitten by infected fleas or being exposed to patients with pneumonic plague by: Understanding the modes of transmission and heeding any plague advisories while visiting the southwest U.S. […] Additionally, a Y. pestis vaccine is recommended for persons whose occupations put them at high risk for exposure to Y. pestis or plague-infected rodents. […] Vaccine may be considered for persons traveling to, or residing in, areas with epizootic or epidemic plague.

• #20 Plague – Controls | Occupational Safety and Health Administration

  http://www.osha.gov/plague/controls

  There are a variety of controls that should be implemented in order to protect workers from exposure to plague. […] National infection control guidelines prescribe specific precautions to be taken when treating patients with known or suspected plague. These precautions include „Standard”, „Droplet” and „Airborne” Precautions, under certain circumstances. Patient isolation and similar precautions may also be necessary. […] Similar infection control precautions, as listed previously for live individuals, should be implemented for the post-mortem care of plague patients. These precautions apply to all workers performing post-mortem procedures on plague patients, including healthcare workers, morticians, forensic personnel, or others. […] The risk of re-aerosolization of plague bacteria from contaminated persons is considered low. In situations where there may have been gross exposure to plague, personal decontamination can be performed by removing contaminated clothing and washing exposed skin with soap and water.

• #20 Plague – Controls | Occupational Safety and Health Administration

  http://www.osha.gov/plague/controls

  The principles of Standard Precautions are generally applied for the cleaning, disinfection, and sterilization of equipment and environmental control in facilities. […] Specific biosafety procedures, including PPE, engineering controls, and additional work practices have been established for handling plague bacteria in laboratories. […] Various actions may be taken by public health authorities to treat and prevent further infections due to a release of plague bacteria. These measures may include mass distribution of medications, surveillance, quarantine, and communication procedures.

• #21 Prevention of plague – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/plague/prevention-plague.html

  Learn how plague can be prevented. […] At this time there is no plague vaccine available in Canada for travellers. […] You can reduce your risk of getting plague by: protecting yourself from flea bites by using insect repellent and avoiding: contact with sick or dead animals, contact with rodents or other wildlife, crowded areas where pneumonic plague is being reported, contact with persons who are sick or are suspected of infection with pneumonic plague. […] If you own a pet in an area where plague is present, you should: keep fleas off your pet(s), not allow your dogs or cats to roam free outside or sleep on your bed.

• #22 Prevention of Plague | Office of Justice Programs

  https://www.ojp.gov/ncjrs/virtual-library/abstracts/prevention-plague

  Prevention of Plague NCJ Number 191807 Journal Morbidity and Mortality Weekly Report Volume: 45 Issue: RR-14 Dated: December 13, 1996 Pages: 1-15 Author(s) Kenneth L. Gage Ph.D.; David T. Dennis M.D.; Theodore F. Tsai M.D. Date Published 1996 Length 16 pages Annotation This report contains revised recommendations by the Advisory Committee on Immunization Practices concerning prevention of plague. […] This report included information and recommendations on vaccination, public health practices, and medical treatment to prevent plague among humans. […] Killed bacteria have been used in plague vaccines since 1896. However, only one vaccine–a formalin-inactivated preparation–is currently licensed for use in the United States. […] Persons should be vaccinated only if they are at high risk for exposure.

• #23 Plague: Recognition, Treatment, and Prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5744195/

  There is still no effective vaccine for plague prevention, although a live attenuated vaccine is used in some countries, such as China and Russia. […] Because Y. pestis is also an important bioterrorism agent and the perpetrators may intentionally use this pathogen to threaten societal stability, clinicians need to pay attention to this rare but harmful disease to prevent its further spread.

• #24

  https://www.ncid.sg/Health-Professionals/Diseases-and-Conditions/Pages/Plague.aspx

  Plague should be suspected in anyone with fever and painful lymphadenopathy who has been to an endemic country. […] Consider antibiotic prophylaxis for the following: Persons exposed to patients with pneumonic plague. Persons exposed to bites of wild rodent fleas during an outbreak or to tissues/fluids of a plague-infected animal. Persons travelling to highly endemic area for short duration. […] A formalin-killed plague vaccine has been used for the following groups: Travellers to endemic or hyperendemic areas. Individuals who must live and work in close contact with rodents. Laboratory workers who must handle live cultures of Y. pestis. Military personnel deployed in plague-endemic areas.

• #25 Without an Approved Vaccine, Plague Cases Continue in 2024 — Vax-Before-Travel

  https://www.vax-before-travel.com/2024/07/12/without-approved-vaccine-plague-cases-continue-2024

  From a prevention perspective, plague vaccines are no longer available in the U.S. However, plague vaccine candidates are in development but are not expected to be commercially available in the immediate future. […] In March 2023, the first mRNA-based, lipid nanoparticle vaccine was found effective against lethal bacteria in mice.

• #26 Department of Health | Communicable Disease Service | Plague

  https://www.nj.gov/health/cd/topics/plague.shtml

  Health care providers, administrators, and clinical laboratory directors should report confirmed or suspect cases immediately to their Local Health Department by telephone. […] While a serious disease, plague can be treated with antibiotics. People who are exposed to plague can also take antibiotics to prevent the illness. […] CDC Guidelines for Antimicrobial Treatment and Prophylaxis of Plague (July 2021)

• #27 Plague

  https://www.michigan.gov/michiganprepares/az/az2/plague

  Plague is an infectious disease that affects animals and humans. It is caused by the bacterium Yersinia pestis. […] Plague is an ancient disease that occurs in irregular cycles. […] Both bubonic and pneumonic plague are readily controlled by standard public health response measures. […] Someone who thinks they have the plague should get immediate medical attention. To prevent illness, a person who has been exposed must receive antibiotic treatment without delay. If an exposed person becomes ill, antibiotics must be given within 48 hours of their first symptoms to reduce the risk of death. […] The Michigan Department of Health and Human Services works closely with physicians to make them aware of the signs and symptoms of plague and laboratories to be able to identify the plague bacteria. Increased surveillance by local health departments is incredibly important in our efforts to detect bioterrorism, investigate potential cases, and ensure that patients will be cared for properly with minimal risk to other individuals. Hospitals, health care providers, and health departments throughout the state are prepared to follow the protocols and recommendations for care set by the Centers for Disease Control and Prevention to make sure patients are safe.

• #28 Antimicrobial Treatment and Prophylaxis of Plague Recommendations for Naturally Acquired Infections and Bioterrorism Response | Technical Resources | ASPR TRACIE

  https://asprtracie.hhs.gov/technical-resources/resource/9965/antimicrobial-treatment-and-prophylaxis-of-plague-recommendations-for-naturally-acquired-infections-and-bioterrorism-response

  These guidelines provide recommendations to healthcare providers on treatment and prophylaxis of plague resulting from naturally occurring disease or a bioterrorism attack.

• #29 Antimicrobial Treatment and Prophylaxis of Plague: Recommendations for Naturally Acquired Infections and Bioterrorism Response · 研飞ivySCI

  https://www.ivysci.com/articles/3540087__Antimicrobial_Treatment_and_Prophylaxis_of_Plague_Recommendations_for_Naturally_Acquired_Infections_and_Bioterrorism_Response

  This report provides CDC recommendations to U.S. health care providers regarding treatment, pre-exposure prophylaxis, and postexposure prophylaxis of plague. […] The guidelines provide recommended best practices for treatment and prophylaxis of human plague for both naturally occurring disease and following a bioterrorism attack. […] Clinicians and public health officials can use these guidelines to prepare their organizations, hospitals, and communities to respond to a plague mass-casualty event and as a guide for treating patients affected by plague.

• #30 Prevention of Plague | Office of Justice Programs

  https://www.ojp.gov/ncjrs/virtual-library/abstracts/prevention-plague

  Vaccination is usually unnecessary when appropriate preventive measures are taken. […] In most instances, plague can be prevented by using an appropriate combination of: (a) personal protective measures; (b) applications of insecticides to home, recreational, and work environments when plague has been detected in local animal flea populations; (c) insecticidal treatment of pets; (d) avoidance of sick or dead animals; (e) environmental modifications to reduce the amount of food and shelter available to rodents; and (f) prophylactic antibiotic therapy for persons who are presumed to have been exposed to infection.

• #31 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/plague.aspx

  Plague is an ancient disease that has caused epidemics of illness and the deaths of millions of people throughout history. During the Black Death of the 14th century, an estimated one-third of the population of Europe died from plague. Today, plague is rare among humans but is found each year among squirrels, chipmunks, and other rodents in California and the southwestern United States. […] People can become infected with plague bacteria if they are bitten by a flea from an infected rodent or have close contact with an infected animal. Most people with plague develop fever and swollen lymph nodes. Plague is treatable with antibiotics but can progress to severe and sometimes fatal illness if diagnosis and treatment are delayed. […] People visiting, hiking, camping, or living in areas where plague occurs should avoid contact with wild rodents and their fleas. Domestic cats are also susceptible to plague and can pass the infection to their owners.

• #32 Plague | Delta County, CO – Official Website

  https://www.deltacountyco.gov/453/Plague

  People can get plague from being bitten by a rodent flea that is carrying the plague, by handling an infected animal, or even by inhaling the bacteria from infected animals. […] You should avoid contact with all wild rodents, especially sick or dead rodents. […] In western Colorado, prairie dogs are notorious for carrying plague. […] Dogs and cats should be confined so they cannot prey on rodents and then bring the disease home with them. […] Flea prevention should be kept current on all pets, following the direction of your veterinarian. […] Controlling fleas on pets will prevent the transfer of fleas to humans.

• #33 Plague (U.S. National Park Service)

  https://www.nps.gov/articles/000/plague.htm

  Plague is a non-native, infectious disease caused by the bacterium Yersinia pestis, which is generally spread by fleas from infected rodents to other mammals, including humans. […] Post-exposure prophylaxis is also indicated for persons with known exposure to plague. […] By protecting wildlife from plague, we can help protect ourselves. […] PREVENTION: View animals in the wild from a safe distance. Never approach or touch wildlife. Keep pets leashed and up-to-date on flea and tick prevention. Stay on the trail and avoid contact with rodent burrows. Reduce exposure to rodents by eliminating sources of food and nesting places around buildings, removing brush, rock piles, firewood, and food supplies around living areas, and excluding rodents from buildings. Use insect repellent if you think you could be exposed to fleas during activities such as camping, hiking, or working outdoors. Products containing DEET can be applied to the skin as well as clothing, and products containing permethrin can be applied to clothing. Follow instructions on the label.

• #34

  https://www.prevention.com/health/a46754108/human-bubonic-plague-case-oregon/

  The U.S. usually sees 10 or more cases of bubonic plague a year. […] Bubonic plague is treatable with antibiotics. […] All close contacts of the resident and their pet have been contacted and provided medication to prevent illness, Richard Fawcett, M.D., Deschutes County Health Officer, said in a statement. […] If someone isnt treated with appropriate antibiotics, the bacteria can spread to other areas of the body, the CDC says. […] All types of the plague are treated with antibiotics, says Thomas Russo, M.D., a professor and chief of infectious diseases at the University at Buffalo in New York. Drugs like doxycycline and tetracycline can help with bubonic plague. […] If you want to lower your already low risk that your pet will contract bubonic plague, Dr. Russo recommends keeping cats indoors and using flea medication. That will help, he says.

• #35

  https://www.sandiegocounty.gov/content/sdc/deh/pests/plague.html

  When visiting, hiking, camping, or living in areas where plague occurs, avoid contact with wild rodents and their fleas. […] Avoid known plague areas. […] Avoid contact with wild animals and their fleas, especially sick or dead rodents. […] Report sick or dead animals to park rangers or the Vector Control Program. […] Use flea control products on pets. […] Use caution when handling a sick pet that has been in a plague area. […] Avoid face-to-face contact with sick pets or sick humans. […] Contact a doctor right away if you become ill within 8 days of being in a plague area.

• #36 Plague: Overview, Symptoms, and Types (Bubonic, Septicemic and Pneumonic)

  https://www.webmd.com/a-to-z-guides/plague-faq

  Theres no vaccine for the plague in the U.S. So if you have a chance of contact with plague germs, take steps to protect yourself. […] If you travel to Africa, Asia, or South America, check for traveler notices about plague outbreaks on the CDC website. Avoid areas with the plague if you can, and stay away from sick or dead animals while youre there. […] If you live in an area where theres been a case of the plague: […] Fill holes and gaps in your home to stop mice, rats, and squirrels from getting in. […] Clean up your yard. Get rid of piles of leaves, wood, and rocks where animals might make their homes. […] Use bug repellent with DEET to prevent flea bites when you hike or camp. […] Wear gloves if you have to touch wild animals, alive or dead. […] Use flea control sprays or other treatments on your pets. […] Dont let outdoor pets like cats or dogs sleep in your bed.

• #37 Plague: Symptoms, Treatment & Prevention – Toronto & Montreal Travel Vaccination Clinics

  https://cliniquevoyageur.ca/travel-vaccines/plague/

  Note that there is currently no vaccine to prevent plague available in the United States. If you travel to a country at risk, you must prevent flea bites and contact with potentially contaminated animals (especially rats). […] For optimal protection against fleas, you can also use Permethrin-treated clothing and gear, such as pants, socks and boots. Permethrin remains effective even after several washes. […] If you are in an area at high risk for plague, you should take some additional measures. Store food in tightly sealed containers and away from rodents. Be sure that your accommodation has an adequate sanitation system and is free of rodents. […] Protect your pets against fleas (consult a veterinary if necessary), dont let them sleep on your bed and avoid letting them going outside.

• #38 Plague | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/plague/

  Plague could be used as a bioterrorist weapon. […] If you travel to an area endemic for plague and you think that you could be exposed to rodent fleas during activities such as camping, hiking, or working outdoors, use an insect repellent containing DEET. Repellents containing DEET and permethrin can be also applied to clothing for better protection. Visit the CDC site to learn more about prevention. […] Plague is an URGENT notifiable condition and must be reported by phone to the Disease Outbreak Control Division, Disease Investigation Branch on Oahu, or to the District Health Office on the neighbor islands as soon as a provisional diagnosis is established.

• #39 Plague and Other Yersinia Infections – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/bacterial-infections-gram-negative-bacteria/plague-and-other-yersinia-infections

  Doctors monitor people who have had contact with a person who has pneumonic plague. Their temperature is taken every 4 hours for 6 days. […] Also, antibiotics are given to prevent the infection from developing. People over 8 years of age are given doxycycline or ciprofloxacin, and children under 8 years of age are given trimethoprim/sulfamethoxazole. […] Plague vaccines are no longer available in the United States.

• #40 Plague – UF Health

  https://ufhealth.org/conditions-and-treatments/plague

  Plague is a severe bacterial infection that may cause death. The disease affects small mammals, mainly rodents, and humans. […] Plague is caused by the bacteria Yersinia pestis. Rodents, such as rats, carry the disease, which is spread by fleas. […] Today, plague is rare in the United States. An average of about 7 cases occur every year. […] People can get plague in the following ways: […] Being bitten by a flea that carries the plague bacteria from an infected animal. […] Handling an infected animal and coming into contact with body fluid or tissue. […] Breathing in respiratory droplets from an infected human or animal. […] Plague is treated with antibiotics. People with plague need to be treated right away. Treatment should be given if plague is suspected, even before test results come back. If treatment is not received within 24 hours of when the first symptoms occur, the risk for death increases.

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