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Bubonic Plague

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Description: The bubonic plague is a severe infectious disease caused by the bacterium Yersinia pestis, characterized by swollen lymph nodes (buboes), fever, chills, and weakness.
Type: The bubonic plague is caused by a bacterial infection with *Yersinia pestis*. It is not transmitted genetically. Instead, it spreads primarily through the bite of infected fleas that have fed on infected rodents. Human-to-human transmission is rare but can occur through respiratory droplets in cases of pneumonic plague, a secondary form of the infection.
Signs And Symptoms: After being transmitted via the bite of an infected flea, the Y. pestis bacteria become localized in an inflamed lymph node, where they begin to colonize and reproduce. Infected lymph nodes develop hemorrhages, which result in the death of tissue. Y. pestis bacilli can resist phagocytosis and even reproduce inside phagocytes and kill them. As the disease progresses, the lymph nodes can hemorrhage and become swollen and necrotic. Bubonic plague can progress to lethal septicemic plague in some cases. The plague is also known to spread to the lungs and become the disease known as the pneumonic plague. Symptoms appear 2–7 days after getting bitten and they include:
Chills
General ill feeling (malaise)
High fever >39 °C (102.2 °F)
Muscle cramps
Seizures
Smooth, painful lymph gland swelling called a bubo, commonly found in the groin, but may occur in the armpits or neck, most often near the site of the initial infection (bite or scratch)
Pain may occur in the area before the swelling appears
Gangrene of the extremities such as toes, fingers, lips, and tip of the nose.The best-known symptom of bubonic plague is one or more infected, enlarged, and painful lymph nodes, known as buboes. Buboes associated with the bubonic plague are commonly found in the armpits, upper femoral area, groin, and neck region. These buboes will grow and become more painful over time, often to the point of bursting. Symptoms include heavy breathing, continuous vomiting of blood (hematemesis), aching limbs, coughing, and extreme pain caused by the decay or decomposition of the skin while the person is still alive. Additional symptoms include extreme fatigue, gastrointestinal problems, spleen inflammation, lenticulae (black dots scattered throughout the body), delirium, coma, organ failure, and death. Organ failure is a result of the bacteria infecting organs through the bloodstream. Other forms of the disease include septicemic plague and pneumonic plague, in which the bacterium reproduces in the person's blood and lungs respectively.
Prognosis: The prognosis for bubonic plague, caused by the bacterium Yersinia pestis, largely depends on the timeliness and appropriateness of treatment. With prompt antibiotic therapy, the prognosis is generally good, and most patients recover. Without treatment, the disease can be fatal in a large percentage of cases. Clinical factors such as overall health, age, and underlying conditions can also influence the prognosis.
Onset: The onset of bubonic plague typically occurs within 2 to 6 days after exposure to the bacteria Yersinia pestis. It usually begins suddenly with symptoms such as fever, headache, chills, muscle aches, and swollen, tender lymph nodes known as buboes.
Prevalence: The prevalence of bubonic plague is currently very low, with only a few thousand cases reported worldwide each year. It is primarily found in rural and semi-rural areas of Africa, Asia, and South America. Modern antibiotics are effective in treating the disease, which has significantly reduced its impact compared to historical outbreaks.
Epidemiology: Globally between 2010 and 2015, there were 3,248 documented cases, which resulted in 584 deaths. The countries with the greatest number of cases are the Democratic Republic of the Congo, Madagascar, and Peru.For over a decade since 2001, Zambia, India, Malawi, Algeria, China, Peru, and the Democratic Republic of the Congo had the most plague cases, with over 1,100 cases in the Democratic Republic of the Congo alone. From 1,000 to 2,000 cases are conservatively reported per year to the WHO. From 2012 to 2017, reflecting political unrest and poor hygienic conditions, Madagascar began to host regular epidemics.Between 1900 and 2015, the United States had 1,036 human plague cases, with an average of 9 cases per year. In 2015, 16 people in the western United States developed plague, including 2 cases in Yosemite National Park. These US cases usually occur in rural northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon, and far western Nevada.In November 2017, the Madagascar Ministry of Health reported an outbreak to the WHO (World Health Organization) with more cases and deaths than any recent outbreak in the country. Unusually, most of the cases were pneumonic rather than bubonic.In June 2018, a child was confirmed to be the first person in Idaho to be infected by bubonic plague in nearly 30 years.A couple died in May 2019, in Mongolia, while hunting marmots. Another two people in the province of Inner Mongolia, China, were treated in November 2019 for the disease.
In July 2020, in Bayannur, Inner Mongolia of China, a human case of bubonic plague was reported. Officials responded by activating a city-wide plague-prevention system for the remainder of the year. Also in July 2020, in Mongolia, a teenager died from bubonic plague after consuming infected marmot meat.
Intractability: Bubonic plague is not considered intractable. Modern antibiotics, if administered early, are effective in treating the disease. Prompt medical intervention can significantly reduce the risk of severe complications and mortality. However, without timely treatment, the disease can be severe and potentially fatal.
Disease Severity: The severity of bubonic plague can vary, but if left untreated, it can be a severe and potentially fatal disease. Early symptoms include fever, chills, headache, muscle aches, and swollen lymph nodes (buboes). Prompt antibiotic treatment is crucial to reduce mortality.
Healthcare Professionals: Disease Ontology ID - DOID:10773
Pathophysiology: Pathophysiology of Bubonic Plague:

The bubonic plague is caused by the bacterium Yersinia pestis. When a human is bitten by an infected flea, Y. pestis enters the skin and travels through the lymphatic system. It localizes in lymph nodes, causing them to become swollen and painful, forming characteristic buboes. The bacteria replicate within the lymph nodes, leading to inflammation, necrosis, and systemic infection if not treated promptly.

Nanotherapeutics:
While there are no widespread nanotherapies specifically for bubonic plague currently in standard clinical use, nanomedicine is an area of active research. Nanoparticles are being explored for their potential to deliver antibiotics more effectively, target immune responses, and possibly offer novel forms of prophylaxis against Y. pestis.
Carrier Status: Carrier Status: The primary carriers of bubonic plague are rodents, particularly rats. The disease is transmitted to humans through the bite of infected fleas that have fed on these rodents.

Nan: Not applicable in this context.
Mechanism: Bubonic plague is primarily caused by the bacterium Yersinia pestis. It is transmitted to humans through the bite of an infected flea. When an infected flea bites a human, Yersinia pestis enters the bloodstream and targets the lymphatic system.

**Mechanism**:
1. **Flea Bite**: The flea bite introduces Yersinia pestis into the bloodstream.
2. **Lymphatic Spread**: The bacteria travel to the nearest lymph nodes, where they multiply.
3. **Formation of Buboes**: The multiplication of bacteria in the lymph nodes causes them to swell and form painful, swollen lymph nodes known as buboes.

**Molecular Mechanisms**:
1. **Immune Evasion**:
- **Type III Secretion System (T3SS)**: Yersinia pestis uses T3SS to inject effector proteins into host macrophages, neutrophils, and dendritic cells.
- **Yops (Yersinia outer proteins)**: These proteins disrupt the host immune response by inhibiting phagocytosis and inducing apoptosis in immune cells.

2. **Iron Acquisition**:
- **Ybt (Yersinia bacteriophage)**: The bacteria produce siderophores like yersiniabactin to sequester iron from the host, which is essential for their growth and virulence.

3. **Plasminogen Activator Pla**:
- **Pla Protease**: This protease degrades fibrin clots, allowing for better dissemination of the bacteria through the host tissues.

Understanding these mechanisms is vital for developing treatments and preventative measures against this deadly disease.
Treatment: Several classes of antibiotic are effective in treating bubonic plague. These include aminoglycosides such as streptomycin and gentamicin, tetracyclines (especially doxycycline), and the fluoroquinolone ciprofloxacin. Mortality associated with treated cases of bubonic plague is about 1–15%, compared to a mortality of 40–60% in untreated cases.People potentially infected with the plague need immediate treatment and should be given antibiotics within 24 hours of the first symptoms to prevent death. Other treatments include oxygen, intravenous fluids, and respiratory support. People who have had contact with anyone infected by pneumonic plague are given prophylactic antibiotics. Using the broad-based antibiotic streptomycin has proven to be dramatically successful against the bubonic plague within 12 hours of infection.
Compassionate Use Treatment: Bubonic plague, caused by the bacterium Yersinia pestis, is typically treated with antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin. For compassionate use treatments or off-label and experimental options, certain newer antibiotics or treatments might be considered in specific or severe cases. These could include:

1. **Moxifloxacin**: An antibiotic that has shown efficacy in treating a range of bacterial infections, potentially used in cases where first-line treatments are not effective or available.

2. **Levofloxacin**: Another fluoroquinolone antibiotic that might be considered under compassionate use if standard treatments are unavailable or unsuitable.

3. **Tigecycline**: A newer antibiotic related to tetracycline that might be used off-label in multidrug-resistant cases of plague.

4. **Vaccine candidates**: Experimental vaccines are under development and might be considered in outbreak situations under investigational protocols.

It is important to consult medical professionals and relevant health authorities for the latest treatment guidelines and to get approval for compassionate use or experimental treatments.
Lifestyle Recommendations: For the bubonic plague, lifestyle recommendations include:

1. **Avoid Contact with Infected Animals**: Limit exposure to rodents and fleas, which are common carriers of the plague bacteria (Yersinia pestis).

2. **Maintain Cleanliness**: Ensure good sanitation and hygiene to reduce rodent populations in and around living areas.

3. **Use Preventive Measures**: Apply insect repellents when in areas known to have fleas, and consider using flea control products on pets.

4. **Wear Protective Clothing**: When in high-risk areas, wear long sleeves and pants to minimize skin exposure.

5. **Seek Prompt Medical Attention**: Early treatment is crucial. If you suspect you've been exposed or experience symptoms such as swollen lymph nodes, fever, or chills, consult a healthcare provider immediately.

6. **Stay Informed**: Be aware of current outbreaks and avoid traveling to affected regions if possible.
Medication: The primary medication for treating bubonic plague is antibiotics. The most commonly used antibiotics include streptomycin, gentamicin, doxycycline, and ciprofloxacin. Prompt treatment with these antibiotics is crucial to effectively manage and reduce the severity of the infection.
Repurposable Drugs: There are some drugs that have been explored for repurposing to treat bubonic plague, a disease caused by the bacterium Yersinia pestis. Although the primary treatment remains antibiotics such as streptomycin, gentamicin, doxycycline, and ciprofloxacin, other drugs have been considered for repurposing:

1. **Chloramphenicol:** Initially used for bacterial infections, it has shown effectiveness in treating plague, particularly when the person is allergic to first-line antibiotics.
2. **Levofloxacin:** This is a fluoroquinolone antibiotic that has shown potential in treating plague infections.

These repurposable drugs may offer alternative treatment options, especially in case of resistance or allergy to standard antibiotics.
Metabolites: For bubonic plague, which is caused by the bacterium *Yersinia pestis*, there are no specific unique metabolites associated with the disease. The primary diagnosis typically relies on bacterial culture, polymerase chain reaction (PCR), and serological tests rather than metabolite analysis.
Nutraceuticals: There are no established nutraceuticals for the treatment or prevention of bubonic plague. Prompt medical treatment with antibiotics remains the primary course of action for managing this serious infection.
Peptides: The term "peptides" in relation to bubonic plague can refer to specific sequences of amino acids that may be part of the pathogen Yersinia pestis' structure or its virulence factors. Peptides might also be used in developing diagnostic tests or treatments, such as peptide-based vaccines or antimicrobial peptides. However, "nan" does not provide sufficient context or information for further elaboration. If you need details on a specific aspect, please let me know.