The plague, caused by the bacterium Yersinia pestis, has ravaged the planet for thousands of years. Because of its high lethality, it has the potential for being a very effective biological weapon. Unlike smallpox, the virus can still be found naturally all over the planet. And while some forms of infection can be treated, the most contagious form is fatal 50% of the time, even with the best medical care.
There have been three major epidemics of plague in history. In 541, it is believed the plague killed 60% of the population of Europe, North Africa, and parts of Asia. Between 1346 and 1352, the Black Death killed a third of Europe. And in 1855, an outbreak started in China, spreading to all the continents, killing 12 million in China and India alone.
Modern understanding of the nature of the disease and pest control has all but eliminated plague as a serious threat to the population as a whole. While plague still exists in the wild animal population, very few people are infected any more.
The plague can take three basic forms, but all are caused by the same pathogen. The difference lies in how the bacteria attacks the body.
Bubonic plague is one form that infection can take. Bubonic refers to an inflamation of the lymph nodes. This form of plague is generally transmitted by the bite of an infected flea, and is the most common naturally occuring form. It is believed to have been the form most common during the Black Death.
Another form a plague infection takes is septicemic. This is a highly lethal form of plague, where the bacteria spreads beyond the lymph nodes, into the major organs of the body. This causes massive internal hemorhaging and gangrene, and is almost always fatal.
The third and most contagious form of plage is pneumonic plague. As the name implies, this infection is characterized by a pneumonia when the virus concentrates in the lungs. This happens in about 12% of the cases of bubonic or septicemic plague. The resulting coughing causes the virus to be expelled into the air, where it is easily breathed in by others. This form of infection is almost always fatal.
The symptoms of pneumonic plague include fever, fatigue, and coughing with bloody or watery sputtum. Incubation is 1 to 6 days, with 2 to 4 being the most common. Treatment includes streptomycin, getamicin, doxycycline and ciprofloxacin. However, because the disease can be so devastating to the lungs so quickly, ventilators may be necessary in many cases.
Bubonic plague symptoms are sudden fever, chills and weakness, followed by swollen painful lymphnodes in the groin and armpits. With out treament, respiratory failure and death can follow in a few days.
The Soviets manufactured many tons of weapons grade plague that could be dispersed via an aerosol.. Delivered as an aerosol, it easily infects victims by being breathed in. Once infected, secondary infections of pneumonic plague will further spread the disease. In World War II, the Japanese dropped plague infected fleas on cities in China, starting locallized epidemics. A case of pneumonic plague in India caused a half million people to flee the area in panic. US Government training exercises show that an intentional release of plague in a city would quickly overwhelm health care facilities and lead to severe civil unrest.
Protecting oneself from exposure would involve controlling vectors, specifically fleas and rodents, although cats have contracted the disease too. Wearing a good mask (N95 or N100) if anywhere near a possibly contagious person would be critical too. With an intentional release, infection would likely be unknown until symptoms arise 1 to 6 days later.
While "experts" think the likelihood of an attack is very low, I personally think plague may be the biological weapon of choice for terrorists. Small pox would so quickly spread around the world that even a terrorist would have to think twice before using it. Plague, however, could be contained to a specific country, and is even more deadly than smallpox. Released into a large buildings ventilation system, thousands could be infected before anyone knew. And the panic that would ensue could devastate a city.
Information in this article was taken from the book, "When Every Moment Counts", by Dr. Bill Frist, US Senator.
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