Plague (Human)
Primary reference(s)
Dennis, D.T., K.L. Gage, N. Gratz, J.D. Poland and E. Tikhomirov, 1999. Plague Manual:
Epidemiology, Distribution, Surveillance and Control. WHO/CDS/CSR/EDC/99.2. World Health
Organization. Accessed 13 December 2019.
Additional scientific description
Yersinia pestis is usually found in small mammals, mainly rodents, and their fleas (WHO, 2017).
Plague is one of the most virulent and potentially lethal bacterial diseases known, and fatality rates remain high among patients who are not treated in the early stages of infection (WHO, 2017).
Humans can be infected through the bite of infected vector fleas, unprotected contact with infectious body fluids or contaminated materials and the inhalation of respiratory droplets/small particles from a patient with pneumonic plague (WHO, 2017).
Plague is characterised by a rapid onset of fever and other systemic manifestations of gram-negative bacterial infection. It is diagnosed clinically and through laboratory confirmation (Dennis et al., 1999).
The World Health Organization has published guidance on case classification and surveillance standards (WHO, 2006).
Metrics and numeric limits
Not applicable.
Key relevant UN convention / multilateral treaty
International Health Regulations (2005), 3rd ed. (WHO, 2016).
Examples of drivers, outcomes and risk management
Plague is most frequently transmitted by the bites of rat fleas, especially in low hygiene settings. It can be transmitted during the skinning and handling of carcasses of wild animals such as rabbits and hares, prairie dogs, wildcats, and marmots (WHO, 2017). It can also result from the ingestion of undercooked contaminated meat (WHO, 2017).
Plague can also be acquired by inhalation of infective respiratory droplets and perhaps by manual transfer of infected fluids to the mouth during the handling of infected animal tissues (WHO, 2017).
Preventative 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. People should be advised to avoid direct contact with infected body fluids and tissues (WHO, 2007).
When handling potentially infected patients and collecting specimens, standard precautions should apply (WHO, 2017).
References
Dennis, D.T., K.L. Gage, N. Gratz, J.D. Poland and E. Tikhomirov, 1999. Plague Manual:
Epidemiology, Distribution, Surveillance and Control. WHO/CDS/CSR/EDC/99.2. World Health
Organization. Accessed 13 December 2019.
WHO, 2006. Weekly Epidemiological Record. 81:273-284. World Health Organization (WHO). Accessed 25 September 2020.
WHO, 2007. Plague. World Health Organization (WHO). Accessed 8 April 2021.
WHO, 2016. International Health Regulations (2005), 3rd ed. World Health Organization (WHO). Accessed 26 September 2020.
WHO, 2017. Plague. World Health Organization (WHO). Accessed 13 December 2019.