Plague

Plague is a serious bacterial infection caused by Yersinia pestis, transmitted mainly through the bite of infected fleas carried by rodents. It occurs in localised foci in parts of Tanzania and is a notifiable disease requiring urgent reporting and outbreak response.

• Bubonic plague: sudden fever, chills, and a painful, swollen lymph node (bubo), often in the groin, armpit, or neck
• Septicaemic plague: fever, shock, and bleeding without a prominent bubo
• Pneumonic plague: fever, cough, difficulty breathing, and chest pain — this form spreads directly between people through respiratory droplets and can progress rapidly

• Caused by the bacterium Yersinia pestis.
• Transmitted to humans mainly through the bite of infected fleas that have fed on infected rodents.
• Pneumonic plague can also spread from person to person via respiratory droplets.
• Risk is higher in areas with rodent infestation and in specific known plague-affected localities.

• Diagnosis is suspected clinically based on the characteristic bubo, fever, and history of possible flea exposure or contact with rodents in a known-affected area.
• Laboratory confirmation is obtained through microscopy and culture of bubo aspirate, blood, or sputum (for pneumonic plague), performed at a reference laboratory.

Plague is a medical emergency requiring immediate treatment on clinical suspicion, without waiting for laboratory confirmation.

Streptomycin or gentamicin given by injection is the treatment of choice; doxycycline or ciprofloxacin are effective oral or intravenous alternatives.

Pneumonic plague additionally requires strict respiratory isolation of the patient to prevent person-to-person spread, along with prompt antibiotic treatment.

Close contacts of a pneumonic plague case are offered antibiotic prophylaxis, and all suspected or confirmed cases must be reported immediately to health authorities for outbreak investigation and rodent/flea control measures.

• Control rodent populations around homes and grain stores.
• Reduce flea exposure through appropriate insecticide use in known-affected areas.
• Avoid handling sick or dead rodents.
• Seek immediate care for sudden fever with a painful swollen lymph node, especially in a known plague-affected locality.
• Report suspected cases promptly, since rapid response limits outbreak spread.