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Medical File No. 002

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Name of disease: Plague

Cause and Plague is a rampant fever-causing disease fatal to humans that is caused by Yersina
transmission pestis bacteria. The disease, which infects wild rodents and rats, strikes humans
randomly when a multiplying rodent population encounters a human population in
distress, including extreme overcrowded conditions and poor sanitation.
Plague bacteria are transmitted from one rat to another, from rats to humans and
from humans to humans, by means of the bite of a rat-flea carrier. When the flea
bites an infected animal or human, it sucks blood containing the plague bacteria,
which multiply rapidly in the flea’s digestive tract. With its next bite, the flea transmits
the bacteria to its victim’s blood, infecting that victim. The bacteria are sometimes
transmitted from one human to another directly by coughing, in which case it causes
pneumonic plague, which is violent and fatal.

Symptoms When plague bacteria reach the regional lymph nodes they cause the gland to swell
and to huge proportions. The ancients called this swelling a “bubo,” hence the term
progression “bubonic plague.” After an incubation period of two to six days, the disease breaks
out, presenting as high fever accompanied by chills and swelling of the lymph nodes.
Multiple organ failure ensues within hours to days. In untreated patients the disease
is usually fatal.
In some cases plague bacteria enter the blood stream before they cause swelling
of the lymph nodes. Transmission of the bacteria to the various organs through the
blood stream is rapidly fatal.

Treatment Plague is rare today; however, it still strikes humans sporadically in various places
and worldwide. When there is clinical suspicion that a patient is infected with plague,
medications doctors have at their disposal a number of antibiotics that can eliminate the bacteria
and heal the disease.

Notes In antiquity, when physicians were unable to differentiate between various types
Name of of fever-causing diseases, every epidemic disease was called “plague.” The prophet
physician Jeremiah, describing a future siege of Jerusalem, cries out: “He that abideth in this city
shall die by the sword, and by the famine, and by the pestilence” (21:9). There have
been three plague epidemics according to the clinical presentation of the disease
we know today. The first was the lethal outbreak in the Byzantine Empire in 542 CE,
known as the Justinian Plague. The second, and the most infamous, broke out in 1347
in Europe, killing between a quarter and a third of the population and becoming
known as the Black Death. The third broke out in Asia in the mid-19th century. In
1894, the researcher Alexander Yersin was able to isolate the plague-causing bacteria,
which has since borne his name. Four years later, the researcher Paul-Louis Simond
discovered plague bacteria in dead rats and was able to explain the transmission
and spread of the disease. His research became the basis for the work of the great
bacteriologist Waldemar Haffkine, who was the first to develop an anti-plague vaccine.
Also noteworthy is the localized outbreak of plague that was among the main causes of
Napoleon’s failure to capture Acre in 1799.

Prof. Eran Dolev Signature

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