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Plague

Last update: 2022-01-27

Key facts

Transmission

  • Bites of infected fleas
  • Breathing in droplets from the cough of an infected person or animal (cats)
  • Touching or skinning infected live or dead animals (such as rats, rabbits, squirrels or prairie dogs)

Symptoms

  • Sudden fever, chills, head and body-aches and weakness, vomiting and nausea.
  • Small lumps on the body that are swollen, hard and painful (called “lymph nodes”). These can turn into sores that discharge fluid.
  • Stomach pain, shock, and sometimes bleeding into the skin or inside the body; skin may turn black and die, especially on fingers, toes and nose.
  • Lung infection that starts very quickly, and causes difficulty with breathing, chest pain, coughing (sometimes of blood or mucous).
  • The person may stop breathing; the body may shut down, causing death.

Prevention

  • Reduction of rodent habitats
  • Social mobilization and behaviour change communication
  • Early identification of cases and treatment with antibiotics
  • Repair and screening of holes or cracks in houses
  • Storage of food in rodent-proof containers
  • Use of raised beds or sleeping areas
  • Safe handling and disposal of animal carcasses

Vulnerable people

  • Everyone in the community is vulnerable to plague
  • Young children, older people and people with other illnesses or health conditions may have a higher risk of severe illness

If an epidemic occurs

  • Detect plague cases rapidly and refer them to health facilities for early treatment with antibiotics
  • Employ social mobilization and behaviour change communication
  • Control fleas using environmental and chemical hygiene BEFORE controlling rats (eg, setting traps)
  • Actively search for rat carcasses and dispose of them correctly
  • Handle and dispose of animal carcasses safely
  • Avoid direct contact with people who have plague (caregivers should remain a distance of at least one metre from persons who are sick)
  • Caregivers and health workers should wear personal protective equipment (gloves, mask, gown/apron)
  • Isolate patients with pneumonic plague (lung infection)
  • Give antibiotics (chemoprophylaxis) to people who have been in close contact with a person who has pneumonic plague
  • Repair and screen holes and cracks in walls; store food in rodent-proof containers
  • Use raised beds or raise sleeping areas
  • Provide safe and dignified burials

Community-based assessment - questions

Make a map of the community and mark the information you gather on the map. Record other details.

  • When did people start to fall sick with plague?
  • How many people have fallen sick with plague? Where?
  • How many people have died? Where?
  • How many people live in the affected community or area? How many children under five years of age live in the area?
  • Who and where are the vulnerable people?
  • What are the community’s burial traditions and funeral procedures and practices?
  • How do people in the community store their food? (Are rats or other rodents able to eat it?)
  • Do people in the community sleep at ground level or on raised beds?
  • Do community members have any risky habits or practices when they come into contact with dead or live rodents?
  • Are there handwashing facilities in the community or at the health centre? Are soap and water always available?
  • Where are the local health facilities and services? (Include traditional and community carers.)
  • What are the community’s habits, practices and beliefs about caring for and feeding sick people. When babies and infants are sick, do women continue to breastfeed them?
  • Is a social mobilization or health promotion programme in place?
  • Which sources of information do people use most?
  • Are rumours or is misinformation about plague spreading in the community?