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Plague: Yersinia pestis 

Plague: Yersinia pestis
Chapter:
Plague: Yersinia pestis
Author(s):

Michael Prentice

DOI:
10.1093/med/9780198746690.003.0121
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date: 07 March 2021

Bubonic plague is a flea-borne zoonosis caused by the Gram-negative bacterium Yersinia pestis, which mainly affects small burrowing mammals including domestic rats. Human disease occurs in endemic countries—currently mainly in Africa (including Madagascar)—following bites from fleas recently hosted by a bacteraemic animal. Historical use of Y. pestis as a biological warfare agent has raised fears of its future use in bioterrorism. The commonest presentation is acute painful lymphadenitis (80–95% of suspected cases), with sudden onset of fever, chills, weakness, headache, and development of an intensely painful swollen lymph node (bubo). Primary septicaemia with no bubo occurs in 10% of cases. Spread to the lungs occurs in less than 10% of cases, resulting in pneumonia which can result in onward respiratory transmission by droplet infection. Overall mortality without treatment is 50–90%.

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