PLAGUE

SWINE - an acute infectious disease; It is characterized by severe intoxication, fever, lymph nodes, skin and lungs.

Vozbuditel- Yersinia pestis, the fixed size of 0.5 - 1.5 microns, Gram-negative, unstable outside the body. Disinfectants, boiling, antibiotics have a devastating effect on her.

Plague refers to a quarantine disease. The natural foci of sources and reservoirs of the pathogen infection is rodents. The main of them - marmots, ground squirrels and gerbils; possible contamination of humans by rodents (especially in the mass of the breeding season) and lagomorphs. The source and reservoir of the infectious agent may be the rat (gray and black), rarely house mice, cats and camels.

Outbreaks of plague occur where the source of the infectious agent is a person - the patient primary or secondary pneumonic plague, and there is also a risk of infection when in contact with the corpse of the dead from the plague (in the process of washing, a funeral ritual).

Carriers pathogen - different kinds of fleas. Human infection occurs through vector-borne (by the bite of an infected flea); contact (when removing the skins from the plague-infected rodents, fishing, birds, slaughtering and meat cutting sick camel in contact with household goods, patient secretions containing pathogens); food (by eating foods contamination plague pathogens, such as insufficiently thermally processed meat of sick plague camels, marmots). Especially dangerous is the patients pneumonic plague, by which the pathogen can be transmitted by airborne droplets.

The clinical picture. The incubation period ranges from several hours to 6 days, vaccinated - up to 10 days. There are bubonic (skin-bubonic), pulmonary and septicemic plague.

Usually the disease begins abruptly: there are strong chills, headache , muscle aches and a feeling of weakness, body temperature rises to 39 - 40 ° C. The patients are restless, fidgety. Face hyperemic, expressed conjunctivitis , eyes shining feverishly, tongue coated thick white coating ( "Chalk"), Patriotic, it is often a tremor . The mucous membrane of the mouth is dry, the tonsils are enlarged, ulcerated. In severe disease marked cyanosis , facial expression appears suffering and horror, his features sharpened. Are developing insomnia, delusions , hallucinations , agitation, slurred speech, ataxia . Tachycardia is 120 - 160 beats per minute, heart arrhythmia are observed, a sharp drop in blood pressure, shortness of breath . The liver and spleen are enlarged. The skin often found haemorrhagic or pustular rash. Sometimes the skin at the site of pathogen penetration is formed as a primary affect spots which consistently turns to papule, vesicle, pustule. Pustules sharply painful, opened shortly, appears slowly healing ulcer.

In the most common form of bubonic from the first day of the disease there is severe pain at the site of the developing bubo, which causes the patient to take a forced situation; palpable lymph node in the form of a small sickly seal, which then increases the surrounding tissue and skin is infiltrated and merge into a tight without precise contours lumpy conglomerate formed plague bubo. The skin in the first few days is not changed, then it becomes hard, becomes purple-bluish color, 6 -8 th days of illness in the middle of a bubo appear softening and floating. The patient's condition improved. On the 8-12 th day of illness bubo is opened, stands a thick yellowish-green pus, formed slowly scarring ulcers. In case of unfavorable course of the disease develop secondary plague pneumonia or hemorrhagic septicemia.

Pneumonic plague occurs most difficult and dangerous to others. It may occur primarily or secondarily as a complication of other forms. Intoxication pronounced, marked severe chest pain, cough with bloody sputum, cyanosis , dyspnea , tachycardia , tremor . After 2-3 days develops coma , pulmonary heart disease.

Septic plague form of severity similar to the pneumonic form, can also be primary and secondary. In addition to severe intoxication, characterized by massive bleeding in the skin and mucous membranes, bleeding (gastrointestinal, lung, kidney, uterine). Diagnosis is based on clinical, epidemiological history data (stay to the disease in the territory of a natural focus, contact with rodent flea bites, etc.) And laboratory results. Most importantly, the plague pathogen isolation of the material from the patient (or punctate discharge bubo, blood, sputum, nasopharyngeal swab, and so on. D.).

Treatment. Patients were immediately admitted to specialized hospitals. Causal treatment is carried drugs tetracycline, streptomycin, chloramphenicol, ampicillin in the highest dose for 7 - 10 days. Carry out detoxication therapy (5% glucose solution with ascorbic acid, polyionic solutions gemodez, reopoligljukin; injected strofantin, sulfokamfokain, menadione, and others.).

Prevention. Activities are conducted in two main areas: surveillance of natural foci of plague and the prevention of a possible introduction of the disease in other countries. On the territory of natural foci conducted explanatory work among the population on the measures of prevention of plague, on epidemic indications made specific preventive live vaccine.

Of particular importance in the prevention of plague is the early detection of the first cases of human disease. If you suspect a disease you must report this immediately to the superior health authorities, and quickly begin to deploy anti-epidemic measures. Medical practice, revealing the patient with suspected plague should stop further reception of patients, close the doors and windows, put a post in the room to stop the circulation of patients and staff. On the phone, or through a messenger notified the head physician hospital, through requesting protective clothing, means of emergency prevention (streptomycin, etc.), medicines, disinfectants, health products. Before the arrival of consultants team doctor provides medical care to the patient, of the list of persons to communicate with patients. Suspicious persons plague on the disease was isolated and hospitalized immediately. Persons who come into contact with patients infected things, corpse, isolated for 6 days, exposed to patients with pneumonic plague are placed individually, conduct medical supervision with daily thermometry. These persons, as well as serving the medical staff carried out an emergency chemoprophylaxis with tetracycline 0.5 g orally 3 times a day or chlortetracycline inside of 0.5 g 3 times a day for 5 days. All personnel serving the sick, working in full anti-plague suit (overalls or pajamas, a robe, a hood or a big scarf, cotton-gauze mask or respirator or gas mask, goggles, boots, socks, hat, rubber gloves); after the end of the staff takes full sanitation, living in a dedicated room, and systematic under medical supervision.

Organize monitoring of the health of the population, all identified patients hospitalized with fever to eliminate plague disease. Spend restrictive (quarantine) measures aimed at preventing the spread of infection beyond the hearth. The focus of the current exercise and the final disinfection, disinfestation and deratization in the field and in the village (if indicated).