Plague
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?
Volunteer actions
01. Community-based surveillance
02. Community mapping
03. Communicating with the community
04. Community referral to health facilities
05. Volunteer protection and safety
06. Personal protection equipment (PPE) for highly infectious diseases
19. Psychosocial support
20. Isolating sick people
Plague
23. Chemoprophylaxis
26. Respiratory hygiene and coughing etiquette
28. Physical distancing
29. Hygiene promotion
34. Handwashing with soap
35. Handwashing in a highly infectious epidemic
36. Vector and reservoir control
38. Waste disposal and clean-up campaigns
Plague
41. Handling and slaughtering animals
43. Social mobilization and behaviour change