Severe acute bacterial infection with high fatality rate transmitted by infected rodent fleas. It is a notifiable disease.
Cause
- Yersinia pestis (a coccobacillus) transmitted from ground rodents to man by bites from infected fleas
- It may also be spread from person to person by droplet infection and may occur in epidemics
Clinical features
TYPE | FEATURES |
---|---|
Bubonic (A20.0) |
|
Pneumonic (A20.2) |
|
Septicaemia (A20.7) |
|
Differential diagnosis
- Malaria, typhoid
- Lymphogranuloma venereum
- Pneumonia
Investigations
- Bubo aspirate: for microscopy, C&S
- Blood and sputum: check for presence of the bacilli
Management
- Doxycycline 100 mg every 12 hours for 14 days
Child > 8 years: 2 mg/kg per dose
Alternatives:
- Chloramphenicol 500 mg orally or IV every
6 hours for 10 days
Child: 25 mg/kg per dose - Or gentamicin 1.7 mg/kg (adult and child) IV or IM every 8 hours for 7-10 days
Note
- For use in pregnancy, consider gentamicin
Prevention
- Health education
- Improved housing
- Destruction of rats (rodents) and fleas
- Early detection and treatment to reduce further spread