Prevention and Control

THE MYTH

Plague - Suggested Preventions and Cures How they were supposed to work ?

What they actually did :

Carry Flowers or wear a strong perfume The smells would help to ward away the disease.Coat the victims with mercury and place them in the oven. The combination of mercury and heat from the oven would kill off the disease. This could acutally increase the likelihood of death - mercury is poisonous and the heat from the oven caused serious burns.Drink hot drinks The victim would then sweat out the disease

Many doctors, knowing that they could do nothing for plague victims, simply didn't bother trying to treat the disease. Those that did made sure that they were as protected as possible from the disease by wearing the 'uniform' shown below.

Leather Hat:

Mask:

WHAT SHOULD BE DONE?

To protect against possible hantavirus infection, scientists wear protective suits when examining a mouse with fleas that can harbor plague bacteria.

Risk reduction: Attempts to eliminate fleas and wild rodents from the natural environment in plague-infected areas are impractical. However, controlling rodents and their fleas around places where people live, work, and play is very important in preventing human disease. Therefore, preventive measures are directed home, work, and recreational settings where the risk of acquiring plague is high. 

A combined approach using the following methods is recommended:

• Environmental sanitation

• Educating the public on ways to prevent plague exposures

• Preventive antibiotic therapy

and, rarely, vaccines

Environmental Sanitation: Effective environmental sanitation reduces the risk of persons being bitten by infectious fleas of rodents and other animals in places where people live, work, and recreate. It is important to remove food sources used by rodents and make homes, buildings, warehouses, or feed sheds rodent-proof. Applying chemicals that kill fleas and rodents is effective but should usually be done by trained professionals. Rats that inhabit ships and docks should also be controlled by trained professionals who can inspect and, if necessary, fumigate cargoes.

Public Health Education: In the western United States, where plague is widespread in wild rodents, people living, working, or playing where the infection is active face the greatest threat. Educating the general public and the medical community about how to avoid exposure to disease-bearing animals and their fleas is very important and should include the following preventive recommendations:

Watch for plague activity in rodent populations where plague is known to occur. Report any observations of sick or dead animals to the local health department or law enforcement officials. Eliminate sources of food and nesting places for rodents around homes, work places, and recreation areas; remove brush, rock piles, junk, cluttered firewood, and potential-food supplies, such as pet and wild animal food. Make your home rodent-proof. If you anticipate being exposed to rodent fleas, apply insect repellents to clothing and skin, according to label instructions, to prevent flea bites. Wear gloves when handling potentially infected animals. If you live in areas where rodent plague occurs, treat pet dogs and cats for flea control regularly and not allow these animals to roam freely. Health authorities may use appropriate chemicals to kill fleas at selected sites during animal plague outbreaks. 

To avoid potential risk of exposure to hantavirus infection, safely clean up rodent-infested areas; Air out infested spaces before cleanup; Spray areas of infestation and all excreta, nesting, and other materials with household disinfectant or 10% bleach solution then clean up, seal in bags, and dispose; Avoid sweeping, vacuuming, or stirring dust until the area is thoroughly wet with disinfectant; Wear rubber gloves; disinfect gloves before removal, and wash hands afterwards. Prophylactic antibiotics: Health authorities advise that antibiotics be given for a brief period to people who have been exposed to the bites of potentially infected rodent fleas (for example, during a plague outbreak) or who have handled an animal known to be infected with the plague bacterium. Such experts also recommend that antibiotics be given if a person has had close exposure to a person or an animal (for example, a house cat) with suspected plague pneumonia.

Persons who must be present in an area where a plague outbreak is occurring can protect themselves for 2 to 3 weeks by taking antibiotics. The preferred antibiotics for prophylaxis against plague are the tetracyclines or the sulfonamides.

Vaccines: Plague vaccine has very limited use. The following persons should consider vaccination: 1) scientists who routinely work with the plague bacterium in the laboratory; and 2) people in plague-infested areas who handle or have close contact with potentially infected animals as part of their routine work (such as rodent biologists).

Fundamental Works

History of plague

Plague has a remarkable place in history. For centuries, plague represented disaster for those living in Asia, Africa and Europe.  It is said, populations were so affected that sometimes there were not enough people left alive to bury the dead. Because the cause of plague was unknown, plague outbreaks contributed to massive panic in cities and countries where it appeared. The disease was believed to be delivered upon the people by the displeasure of the gods, by other supernatural powers or, by heavenly disturbance. Innocent groups of people were blamed for spreading plague and were persecuted by the panicked masses. Plague invokes an intense, irrational fear, disproportionate to its transmission potential in the post-antibiotic/vaccination era.

The Great Plague 1665 In two successive years of the 17th century London suffered two terrible disasters. In the spring and summer of 1665 an outbreak of Bubonic Plague spread from parish to parish until thousands had died and the huge pits dug to receive the bodies were full. In 1666 the Great Fire of London destroyed much of the centre of London but also killed off most of the black rats and fleas that carried the plague bacillus.

Bubonic Plague was known as the Black Death and been known in England for centuries. It was a ghastly disease. The victim's skin turned black in patches and inflamed glands or 'buboes' in the groin combined with compulsive vomiting, swollen tongue and splitting headaches made it a horrible, agonizing killer.

The plague started in the East, possibly China, and quickly spread through Europe. Whole communities were wiped out and corpses littered the streets as there was no one left to bury them.

It began in London in the poor, overcrowded parish of St. Giles-in-the-Field. It started slowly at first but by May of 1665, 43 had died. In June 6137, July 1736 and at its peak in August, 31159 people died. In all, 15% of the population perished during that terrible summer.

Incubation took a mere four to six days and when the plague appeared in a household, the house was sealed, thus condemning the whole family to death! These houses were distinguished by a painted red cross on the door and the words, 'Lord have mercy on us'. At night the corpses were brought out in answer to the cry,' Bring out your dead', put in a cart and taken away to the plague pits. One called the Great Pit was at Aldgate in London and another at Finsbury Fields.

The King, Charles II and his Court left London and fled to Oxford. Many people who could, sent their families away from London during these months, but the poor had no recourse but to stay.

Samuel Pepys in his Diary gives a vivid account of the empty streets in London, as all who could had left in an attempt to flee the pestilence.

It was believed that holding a posy of flowers to the noise kept away the plague and to this day judges are still given a nose-gay to carry on ceremonial occasions as a protection against the plague!

The plague spread to many parts of England. York was one city badly affected. The plague victims were buried outside the city walls and it is said that they have never been disturbed since then, as a precaution against a resurgence of the dreaded plague. the grassy embankments below the walls that can be seen as York is approached are the sites of these plague pits.

A small village in Derbyshire called Eyam, 6 miles north of Bakewell, has a story of tragedy and courage that will always be remembered.

In 1665 a box of laundry was brought to Eyam by a traveller. The laundry was found to be infested with fleas, and the epidemic started! 80% of the people died here and there could have been a terrible outbreak in Derbyshire had the village not had a courageous rector called William Mompesson. he persuaded the villagers not to flee the village and so spread the infection, but to stay until the plague had run its course. His wife was one of the many victims and her tomb can be seen in Eyam church.

Mompesson preached in the open air during the time of the plague, on a rock in a dell, now called Cucklett Church. Every year there is held a Commemorative Service on the last Sunday in August in the dell where he preached. During their 'siege' the villagers dropped the money they were to give to people who brought them provisions into a well so as not to spread the infection on the coins.

In some towns and villages in England there are still the old market crosses which have a depression at the foot of the stone cross. This was filled with vinegar during times of plague as it was believed that vinegar would kill any germs on the coins and so contain the disease.

The plague lasted in London until the late Autumn when the colder weather helped kill off the fleas.

Over the centuries Bubonic Plague has broken out in Europe and the Far East. In 1900 there were outbreaks of plague in places as far apart as Portugal and Australia.

Influenza seems to be the modern form of plague. At the end of World War One an influenza outbreak circled the world during 1918 - 1919. Within a year 20 million people had died world-wide.

Wild rodents in certain areas around the world are infected with plague. Outbreaks in people still occur in rural communities or in cities. They are usually associated with infected rats and rat fleas that live in the home. In the United States, the last urban plague epidemic occurred in Los Angeles in 1924-25. Since then, human plague in the United States has occurred as mostly scattered cases in rural areas (an average of 10 to 15 persons each year). 

There have been a few encounters with bubonic plague in modern times. In the American and Canadian west, from Texas and Oklahoma in the east to the Pacific Ocean in the west, it is most often transmitted from species of squirrels. The last occurrence of transmissions from rats to people, or people to people in the United States occurred in 1924 in Los Angeles. In that epidemic there were 32 cases of pneumonic plague with 31 fatalities. Since then there have been around 16 cases a year in the United States, most connected with rock squirrels and its common flea Oropsylla montana. 

Globally, the World Health Organization reports 1,000 to 3,000 cases of plague every year. In North America, plague is found in certain animals and their fleas from the Pacific Coast to the Great Plains, and from southwestern Canada to Mexico. 

Most human cases in the United States occur in two regions: 

1) northern New Mexico, northern Arizona, and southern Colorado;

and 

2) California, southern Oregon, and far western Nevada. Plague also exists in Africa, Asia, and South America.

PLAGUE AS A WEAPON OF WAR

In the years of World War II the Japaneese army formed a special biological warfare division. This unit worked on developing a method to deliver the plague bacteria to the civilian population of China. They tested the effectiveness of the plague as a weapon of war first on prisoners of war, then on unsuspecting civilians. In their first tests they confined a small group of prisioners in a room with thousands of plague infested fleas. The moratlity rate in these experiments were somewhere in the neighborhood of 50-60 percent. 

The next step was to release the plague on the general population of Manchuria. This was accomplished by planes flying over cities and villages and releasing huge amounts of plague infested fleas over the town. When this proved to be an inaccurate way of spreading the disease, and would periodiocally result in the infection of the air crew, another method was devised. The infected fleas were packed into the shell of a conventional bomb and dropped, exploding just over the targeted towns. While exact figures are not know, it is known that these attacks killed many people and caused wide-spread terror in the towns.

 REFERENCE LINKS:

• About Plauge

• Just one bacillus is enough to infect a person!

• Health Emergency & Preparedness

• Bubonic plague hits San Francisco 1900 - 1909

• The Plague by Justin Turner Saki G.

• Doctors Note You may get Plague(Many other disease) Hazard Chart By providing Name and E-Mail Address