What Are The Warning Signals Of The Plague Epidemic?

The disease is transmitted from rats to man by small insects, (about 2-4 mm) i.e. rat-fleas which act as vector, i.e. they only transmit the disease, but do not suffer from it. Rather, they derive their blood meals from the plague-infected rats till the rats die. While sucking blood from the infected rats, a large number of plague bacilli enter the stomach of rat-fleas where they multiply further. When such fleas bite a rat or man for getting their nourishment, they inject their stomach contents containing large number of plague bacilli into the bite-wound, causing plague in rats or in persons.

In case an epidemic does occur, the early signs and symptoms / warning signals must be borne in mind so that the patient/ s can report at the earliest to their physicians. And if the disease is diagnosed in time and immediately antibiotic treatment started, all early patients will be fully cured, thus preventing the disease from assuming an epidemic form. Also the level of general awareness will rise, to keep the situation under control. Some of these measures will be discussed later.

In an epidemic of plague, people complain of sudden high fever / even up to 105°F, with marked shivering/chills, and soon, within hours or at the most the following day, glandular swellings of the size of an egg appear in the groin, and these are so painful and tender that the patient keeps the limb in touch with the abdomen to reduce the tension in the swellings'. As soon as the limb is stretched, there is a marked increase in pain in the groin.

Since the bite of rat-fleas is usually on the legs, the glands of the groin are mostly involved; hence the disease is called bubo, which means groin, or it is also called bubonic plague. The infection in the glands of the groin reaches from the area of the bite, i.e. the feet/legs, by the lymphatics which drain these glands. However, if the flea-bite is on the arms, the glands of the armpit will become swollen, painful and tender, like the glands in the groin.

Since the disease spreads rapidly and has a limited span (hardly 48-72 hours in untreated cases), there is a possibility of people ignoring its onset in the initial stage. And when that initial life-saving period of a few hours is usually ignored by the patient, this could prove fatal.

All this happens when the public is not aware of the early signals/symptoms of the disease, and the epidemic strikes suddenly and initiates panic.

Therefore, from the above, it can be concluded that the early signals/symptoms of plague must be made known to all, and these must be vigilantly kept in mind so that one is saved from the tragedy of plague, as and when an epidemic occurs.

The earliest warning signals/symptoms of plague may be described as follows:

Sudden high-grade fever with marked shivering, pain and tenderness in the groin/ armpit, followed within hours by the appearance of markedly painful/tender glandular swellings in the groin/ armpit - suspect the onset of plague epidemic.

As regards the bite of the flea on the feet/legs/arms, it is so minute that it can hardly be seen or felt. Hence this does not help in suspecting the disease early. The symptoms of plague appear after an incubation period of about a week, or in severe cases, 3 - 4 days following the flea-bite.