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February 8, 2012
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Plague

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Plague Introduction

Plague is a term applied to an infectious disease that spreads easily and, without antibiotics treatment, can be fatal. The plague has caused more fear and terror than perhaps any other infectious disease in history. It has killed nearly 200 million people and has produced monumental changes, such as marking the end of the Dark Ages and causing the advancement of clinical research in medicine.

  • Although still debated by historians, the plague has been responsible for multiple epidemics and at least 3 great pandemics (epidemics that are spread over a large region or multiple sections of the world).
    • The first plague pandemic spanned from the Middle East to the Mediterranean basin during the 5th and 6th centuries, killing about half the population of those areas.
    • The second pandemic struck Europe between the 8th and 14th centuries, destroying nearly 40% of Europe's population.
    • The third pandemic started in 1855 in China and spread to every major continent.  

  • Alexandre Yersin isolated the bacterium (germ) that causes plague, developed a treatment (an antiserum) to combat the disease, and was the first to suggest that fleas and rats may have been spreading plague during the epidemic of 1894. The plague bacillus (bacterium) was named Yersinia pestis in Yersin's memory.
  • Pandemics have succeeded in spreading the plague to every major continent, with the possible exception of Australia. Unlike smallpox, the plague cannot be wiped out. It lives in millions of animals and on billions of the fleas that live on those animals. The plague is a disease of the desert, the steppes, the mountains, and the forest.
    • In the US, an average of 18 cases per year has been reported during the last few decades. These cases are the mildest form of the illness, and they occur mostly in the Southwest. Prairie dogs of the southwestern plains had once died from the plague. A certain type of squirrel may be vulnerable to contracting the plague in some western states, such as New Mexico, Arizona, Colorado, Utah, and California. Only one case of imported plague has been reported since 1926.
    • Outside the United States, the World Health Organization has reported an annual average of 1,666 cases from 1967-1993. The number of actual cases is probably much higher because many countries fail to diagnose and report the plague. The following countries have reported the most cases of humans infected with the plague since 1979 (in order of most reported cases): Tanzania, Vietnam, Zaire, Peru, Madagascar, Burma, Brazil, Uganda, China, and the US.

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Plague

Personal Protective Equipment Introduction

Personal protective equipment (PPE) refers to the respiratory equipment, garments, and barrier materials used to protect rescuers and medical personnel from exposure to biological, chemical, and radioactive hazards.

  • The goal of personal protective equipment is to prevent the transfer of hazardous material from victims or the environment to rescue or health care workers.

  • Different types of PPE may be used depending on the hazard present. The types of hazards addressed here include biological warfare agents (BWAs), chemical warfare agents (CWAs), and radioactive agents.

  • The most common routes of exposure to these hazards include inhalation (breathing, from the air), skin contact, and ingestion (eating or drinking).

The use of personal protective equipment by the general public for protection against chemical and biological agents is...

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Read What Your Physician is Reading on Medscape

Plague »

Plague, first described in the Old Testament, has persisted into the modern era.

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