Bubonic plague is the best-known manifestation of the bacterial disease plague, caused by the bacterium Yersinia pestis (formerly known as Pasteurella pestis). Bubonic plague is often used synonymously for plague, but it does in fact refer specifically to an infection that enters through the skin and travels through the lymphatics, as is often seen in flea-borne infections. Bubonic Plague kills about 50% of infected patients in 4-7 days. The Bubonic plague is believed by many to be the Black Death that was in Europe in the 1340s.

Pathology and transmission

The Bubonic plague is an infection of the lymphatic system, usually resulting from the bite of an infected flea. The fleas are often found on rodents, and seek out other prey when their rodent hosts die. Once established, bacteria rapidly spread to the lymph nodes and multiply. Yersinia pestis can resist phagocytosis and even reproduce inside phagocytes and kill them. As the disease progresses, the lymph nodes can hemorrhage and become necrotic. Bubonic plague can progress to lethal septicemic plague in some cases.

Symptoms

The most famous symptom of bubonic plague is swollen lymph nodes, called buboes. These are commonly found in the armpits, groin or neck. The bubonic plague was the first step of the ongoing plague. The two other forms of the plague, pneumonic and septicemic, resulted after a patient with the bubonic plague developed pneumonia or blood poisoning.

The plague causes fever and a painful swelling of the lymph glands called buboes, which is how it gets its name. The disease also causes symptoms like spots on the skin that are red at first and then turn black, heavy breathing, continuous blood vomiting, aching limbs and terrible pain.

Treatment

In the modern era, several classes of antibiotics are effective in treating bubonic plague. These include the aminoglycosides streptomycin and gentamicin, the tetracyclines tetracycline and doxycycline and the fluoroquinolone ciprofloxacin. Patients with plague in the modern era usually recover completely with prompt diagnosis, and treatment, although the disease is rarely seen in the industrialized world.

See also

• The Black Death
• List of historical plagues