Dr. Ertan Beyatlı

Black Death (Plague Outbreak)

(Update: ) - general subjects

The Black Death, the Black Plague or the Great Plague Outbreak. The plague epidemic was an infectious disease that caused great devastation in Europe in the Middle Ages (1347-1351). Outbreak Yersinia pestis It is thought to be caused by a bacterium called it.

Plague in Asia and Europe To the death of 200 million people caused. The social foundations of the world have literally changed.

Seeing that the coronavirus (Kovid-19) is spreading from Asia (China, Wuhan) to the world today, Mehmet Akif Ersoy said,history repeats itselfThe sentence comes to mind inevitably.

Black Death - Plague Outbreak

The Black Death, which was also a big blow for the Roman Catholic Church; It has led to the persecution of minorities, especially Jews, Muslims, foreigners and beggars.

Similar epidemics are thought to return to Europe with every new generation; Its effects continued until the 1700s. These include the Italian epidemic of 1629-1631, the Great London Outbreak (1665-1666), the Great Vienna Outbreak (1679), the Great Marseille Outbreak (1720-1722) and finally the Moscow outbreak of 1771.

Although this epidemic was called the "Great Death" in the 14th century, it was described as the "Black Death" in later years. The reason for this is that the skin turns black due to subcutaneous hemorrhages in this disease. Actually, this name is used in a figurative sense, and "black" here means gloomy, troubled, sorrowful.

According to historical records, swelling (bubos) occurred in the groin in this epidemic. Since the same symptoms were observed in the plague disease seen in Asia in the 19th century, the 20th century. the researchers at the beginning of the Black Death Yersinia pestis They concluded that it was the same disease caused by the bacterium named "Rattus rattus", carried by the rat (Rattus rattus) and by the rodent fleas.

Yersinia Pestis, responsible for the plague

What Causes the Plague Outbreak?

Yersinia pestis is a Gram negative bacteria species belonging to the Enterobacteriaceae family. It causes all three types of plague disease (bubonic, pneumonic, septicemic). Y. pestis has caused many pandemics throughout history.

Risk factors for plague outbreaks are domestic cats, rodents, especially rabbits, squirrels or prairie dogs, mice, rats, infected with flea bites.

Plague Outbreak Symptoms

Plague symptoms depend on how the patient was exposed to plague bacteria. Plague can take different clinical forms, but the most common are bubonic, pneumonic, and septicemic.

Plague Types: Bubonic, Septicemic and Pneumonic. Dr. Ertan BEYATLI

Bubonic plague: Sudden fever, headache, chills and weakness, and one or more swollen, tender, and painful lymph nodes (bubo called) develops. This form is usually caused by an infected flea bite. Bacteria multiply in the lymph node closest to where the bacteria enter the human body. If the patient is not treated with appropriate antibiotics, bacteria can spread to other parts of the body.

Septicemic plague: Fever, chills, extreme weakness in patients, stomach pain, shock and possibly bleeding to the skin and other organs develops. Skin and other tissues may turn black and bruise may occur, especially on the fingers and nose. Septicemic plague can occur as the first sign of plague or may develop from untreated bubonic plague. This form is caused by infected flea bites or from carrying an infected animal.

Pneumonic plague: Patients develop a rapidly developing pneumonia with fever, headache, malaise and shortness of breath, chest pain, cough, and sometimes bloody or watery mucosa. An outbreak of pneumonic plague can develop from the inhalation of infectious droplets or develop from untreated bubonic or septicemic plague after bacteria spread to the lungs. Pneumonia can cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only type of plague that can spread from person to person (by infectious droplets).

Physicians dealing with this disease in 17th year Rome (Plague Doctor) was called. A hat, a special beaked mask, a costume and high-heeled leather shoes were worn to make it clear that he was a Plague Doctor.

Plague Doctor: Copper engraving of Doctor Schnabel [Dr. Beak] (Plague doctor in 17th century Rome) satirical macachronic poem ("Vos Creditis, als eine Fabel, / quod scribitur vom Doctor Schnabel")
Plague Doctor: Copper engraving of Doctor Schnabel [Dr. Beak] (Plague doctor in 17th century Rome) satirical macachronic poem ("Vos Creditis, als eine Fabel, / quod scribitur vom Doctor Schnabel")

complications

  • Death. Untreated Plague has a high mortality rate.
  • Gangrene. blood flow may slow and tissue decay may occur. Blood clots can occur in the veins.
  • Meningitis. Rarely, plague can cause inflammation of the membranes surrounding the brain and spinal cord (meningitis).

Diagnosis

Diagnosis is made by sampling the patient, especially blood or a part of the swollen lymph node, and subjecting it to laboratory testing. Once the plague has been identified as a possible cause of the disease, appropriate treatment should begin immediately.

The incubation period (the time between infection and symptoms) is usually 2-8 days. This period can be as short as 1 day for pneumonic plague.

Treatment

Modern antibiotics It is effective in the treatment of plague. Without immediate treatment, the illness can cause serious problems or death.

Plague is a very serious illness, but it can be treated with commonly available antibiotics. Strong antibiotics may be given, such as:

  • gentamicin
  • Doxycycline (Monod, Vibramycin, others)
  • Ciprofloxacin (Cipro)
  • levofloxacin
  • Moxifloxacin (Avelox)
  • chloramphenicol

The sooner a patient receives medical care and proper treatment for plague, the better their chances. People who have been in close contact with highly ill pneumonic plague patients can be evaluated and possibly observed. Preventive antibiotic therapy may also be prescribed depending on the type and timing of personal contact.

Prevention

Reduce rodent habitats around your home, workplace and rest areas. Remove possible rodent food items such as brushes, boulders, junk, messy firewood, and pet and wild animal feed. Make your home and surroundings rodent proof. To prevent contact between your skin and plague bacteria, wear gloves if you touch or wear the skin of potentially infected animals. If you have questions about the disposal of dead animals, contact your local health department. If you think you may be exposed to rodent fleas during activities such as camping, hiking, or working outdoors, use a repellent spray. Products containing DEET can be worn on the skin and clothing with products containing permethrin (always follow the directions on the label). Keep fleas away from your animals by applying flea control products. Free-roaming animals are more likely to come in contact with plague-infected animals or fleas, and you can take them home. If your pet does get sick, contact a veterinarian as soon as possible. Do not allow free-range dogs or cats to sleep in your bed in endemic areas.

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