Plague In India: History, Current Risk, Symptoms, Diagnostic Tests And Cure

Why Is Plague In The News?

Plague has appeared in the news recently after a laboratory worker died of a possible pneumonic plague in Irkutsk, Russia. Following an unnamed incident, the Russian health department has placed nearly 200 people under observation due to the possibility of contractions. Health authorities in other countries have also remained on alert.

While the recent scare has no direct link to the threat in India, it has rekindled old fears of the disease. This is a good opportunity to learn more about the deadly illness and how it can affect us today.

India's History With Plague: Surat Plague Of 1994

Plague is not a new disease in India. The country has in fact seen its share of outbreaks in the past, the most recent of which was in 1994.

It began when pneumonic plague cases were reported in Surat, Gujarat. Following reports of the illness, several other cities such as Mumbai, Kolkata, Delhi, and others, also reported suspected cases. The fear was that the pneumonic plague would spread throughout the country, but it was contained within a matter of weeks.

It is believed that between 500,000 to 1 million residents of Surat fled the city after the outbreak began, fearing that the disease would spread. Several cities also enforced fever screening at their railway stations and airports. However, the panic was largely unwarranted as very few people actually contracted the disease. There were only a handful of officially recorded deaths, and most of them were in Surat.

Since then, India has strengthened its healthcare system and surveillance infrastructure. The Surat plague is also seen as an important lesson that is being used to guide several COVID-19 containment efforts.

India today, however, is free from plague. There have not been any reported cases since 1994. Prior to the Surat outbreak, the last officially recorded cases were several decades ago. Today, sporadic cases of plague are reported occasionally in India from time to time usually in areas with a history of rodent infestation.

So, is plague a risk in India?

Plague is not a risk in India for most people. The disease is not present in Indian cities, and there is no active outbreak at the moment. That said, there are rare cases of plague being reported in the country from time to time.

India has an active disease surveillance system that keeps track of unusual clusters of fever, including plague. The Integrated Disease Surveillance Programme managed by the National Centre for Disease Control (NCDC) ensures that reports of rodent-borne illnesses such as plague are responded to quickly and appropriately.

Is there anything else we need to know about plague?

The good news is that plague is not an active concern in India for the general public. It has been a long time since the last reported cases, and the country has a robust surveillance system in place to detect any possible outbreak early on.

That said, there is no harm in learning more about the illness. Plague tends to make the headlines every now and then, so it is a good idea to be aware of the illness.

What Is Plague?

Plague is an acute infectious disease caused by the bacterium Yersinia pestis. The bacteria are the same ones responsible for the devastating "Black Death" pandemic of the Middle ages that ravaged Europe and Asia.

Today, plague is rare but highly treatable. The illness takes different forms depending on the infection route and the affected part of the body.

The bacteria usually affect rodents and are passed to humans through the fleas that infest these animals. People can contract plague through the bites of infected fleas or by direct contact with infected animals.

In rare cases, pneumonic plague can be transmitted from person to person through respiratory droplets. Plague can also be contracted in laboratory settings if proper safety precautions are not taken. This appears to be the case with the recent pneumonic plague scare in Russia.

The 3 Types of Plague

Depending on the site of infection, plague can take 3 forms:

Bubonic Plague (most common)

Bubonic plague usually develops after a person is bitten by an infected flea or animal. Some of the common symptoms of bubonic plague include:

• Fever, chills, and headache
• General weakness or tiredness
• Painful, swollen lymph nodes (buboes) in the neck, groin, or armpits

Septicemic Plague

Septicemic plague occurs when the bacteria enters the bloodstream directly, or as a complication of another form of the disease, such as bubonic plague. Symptoms of septicemic plague include:

• Fever, chills, and weakness
• Abdominal pain, vomiting, and diarrhea
• Unusual bleeding and bruising
• Black toes, fingers, or nose (in advanced cases)

Pneumonic Plague (most dangerous)

Pneumonic plague is the most deadly form of the illness. This type of plague affects the lungs and can be transmitted from person to person. It usually develops when the bacteria are inhaled. Pneumonic plague can also develop as a complication of other forms of plague, or it can be contracted through direct contact with an infected animal.

Symptoms of pneumonic plague include:

• Sudden fever, headache, and weakness
• Rapid development of pneumonia
• Shortness of breath, chest pain, and cough
• Coughing up blood or fluids that are watery and not mucus-like

Pneumonic plague tends to be severe and is often fatal if not treated. The infection can progress rapidly and become fatal within a few days of the first symptoms appearing.

How Is Plague Contracted?

Plague can be contracted in a number of ways, including:

Flea bites

The most common way of contracting plague is by being bitten by an infected flea.

Direct contact

Another way of getting infected is by coming into contact with the fluids or tissues of an infected animal.

Airborne transmission

Pneumonic plague can be transmitted from person to person through respiratory droplets.

Laboratory exposure

People working in laboratories can get exposed to the bacteria if proper safety measures are not taken.

Plague is not transmitted through casual contact, unlike many other infections. The bacteria need a specific route of entry into the body to cause an infection. The only form of plague that is transmitted through saliva is pneumonic plague, and even then, it requires close contact with the infected person.

How Is Plague Diagnosed?

If plague is suspected, healthcare professionals might recommend a series of diagnostic tests to identify the causative bacteria and determine the most appropriate treatment. Diagnostic tests for plague include:

Plague symptoms can be very similar to those of other illnesses, such as influenza. As a result, it can be difficult to diagnose plague, especially in its early stages. This is why diagnostic tests are so important. The importance of diagnostic testing was noted during the 1994 Surat plague scare, when thousands of feverish patients were tested for the illness before their tests came back negative.

How Is Plague Treated?

Plague is a serious infection, but it can be successfully treated with the right antibiotics. The choice of antibiotic depends on the type of plague and can include:

• Doxycycline
• Gentamicin
• Streptomycin
• Ciprofloxacin

Patients should seek medical attention as soon as possible after being exposed to the plague bacteria or after experiencing symptoms. The sooner the antibiotics are administered, the better the outcome is likely to be.

People with pneumonic plague should be hospitalized and kept in isolation to prevent the disease from spreading to others.

Close contacts of a person with pneumonic plague can be given preventive antibiotics.

Without antibiotics, plague can be fatal, especially in the case of pneumonic plague. Most people with appropriate treatment, however, make a full recovery.

When To See A Doctor?

Seek medical attention if you experience any of the following symptoms:

• Fever with chills, especially if you have been bitten by a flea or have come into contact with wild animals
• A painful, swollen lymph node that appeared suddenly
• Sudden appearance of symptoms of a lung infection, such as cough, shortness of breath, or chest pain

Furthermore, always seek medical attention if you believe you may have been exposed to the bacteria that cause plague. This applies especially if you have traveled to an area where plague cases have been reported. It is also a good idea to consult a doctor if you have any of the symptoms mentioned above, along with a sudden fever.

Testing is especially important because it allows healthcare professionals to identify the cause of your infection and prescribe the most effective treatment. If you have symptoms of plague and a possible route of infection, getting tested is always a good idea.

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