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Plague


Quarantine natural focal disease, characterized by high fever, severe intoxication, the presence of buboes (hemorrhagic-necrotic changes in the lymph nodes, lungs and other organs), as well as sepsis. Pathogen - motionless, barrel-like form of the plague rod.
It refers to the infectious infections. In nature it is preserved due to periodically arising epizootics in rodents, the main warm-blooded hosts of plague microbe (groundhogs, ground squirrels, gerbils). Transmission of the pathogen from the animal to the animal occurs through fleas. Infection of a person is possible by contact (by removing skins and cutting meat), eating contaminated food, flea bites, airborne droplets. The susceptibility of a person is very high. A sick person is dangerous to others, especially patients with a pulmonary form.
Symptoms and course:
The incubation period lasts 3-6 days. The disease begins acutely with a sudden chill and a rapid increase in temperature to 40 ± C. Chills are replaced by fever, severe headache, dizziness, severe weakness, insomnia, nausea, vomiting, pain in the muscles. Intoxication is expressed, frequent disturbances of consciousness, psychomotor agitation, delirium, hallucinations are frequent. Typical shaky gait, redness of the face and conjunctiva, slurred speech (patients resemble drunk). The facial features are pointed, puffy, dark circles appear under the eyes, a suffering face, full of fear. Skin is dry and hot to the touch, a petechial rash, extensive hemorrhages (hemorrhages), darkening on corpses are possible. The symptoms of the cardiovascular system develop rapidly: cardiac enlargement, deafness of tones, increasing tachycardia, falling arterial pressure, arrhythmia, dyspnea, cyanosis. Characteristic of the language: thickened, with cracks, crusts, covered with a thick white coating. The mucous membranes of the mouth are dry. Tonsils are often enlarged, ulcerated, in a soft hemorrhage sky. In severe cases, vomiting is the color of the "coffee grounds", a frequent liquid stool with an admixture of mucus, blood. In urine, an admixture of blood and the presence of protein.
There are two main clinical forms of plague: bubonic and pulmonary. When bubonic there is a sharp pain in the affected lymph glands (often inguinal) before their noticeable increase, and in children underarm and cervical. Regional lymphatic glands are affected at the site of a flea bite. They quickly develop hemorrhagic necrotic inflammation. The glands are soldered together, with the adjacent skin and subcutaneous tissue, forming large bags (buboes). The skin glosses, turns red, then ulcerates, and the bubo opens up. In the hemorrhagic exudate of the gland are a large number of rods of the plague.
When the pulmonary form (primary) appears hemorrhagic inflammation with necrosis of small pulmonary foci. Then there are cutting pains in the chest, palpitation, tachycardia, shortness of breath, delirium, fear of deep inspiration. Cough appears early, with a lot of viscous transparent, glassy sputum, which then becomes frothy, liquid, rusty. The pain in the chest increases, the breathing sharply weakens. Typical symptoms of general intoxication, rapid deterioration of the state, the development of infectious toxic shock. The prognosis is heavy, death usually comes on 3-5 days.
Recognition:
Based on clinical and epidemiological data, the final diagnosis is based on laboratory studies (bacterioscopic, bacteriological, biological, serological).
Treatment:
All patients are hospitalized. The main principles of therapy are the integrated use of antibacterial, pathogenetic and symptomatic therapy. The introduction of desytotoxicaciopic fluids (polshlyukin, rheopolyglucose, hemodez, neokimbensane, plasma, glucose solution, saline solutions, etc.) is shown.
Prevention:
Fight against rodents, especially rats. Observation of persons working with infectious materials or suspected of contracting a plague, preventing the importation of plague into the territory of the country from abroad.