SATV, Kathmandu, October 7- Plague has once again drawn global attention following the suspected death of a laboratory worker in Irkutsk, Siberia, Russia, and the placement of around 200 people who had been in contact with her under health monitoring and quarantine.

A 28-year-old female employee working at a plague research institute in Irkutsk died of pneumonia of unknown cause, prompting an investigation into the possibility of plague infection. Following the incident, people who had been in contact with her were placed under medical observation.

However, according to the latest information, no case of plague has been confirmed in Irkutsk. Russian authorities have informed the World Health Organization that there are currently no confirmed cases of plague in Irkutsk. None of the people who came into contact with the deceased woman have tested positive for plague. Some of them were found to have other infections, including COVID-19 and rhinovirus, but there has been no evidence of plague.

Nevertheless, given that plague can be a serious and potentially fatal disease, it is useful to understand the facts about it. What exactly is plague? Why is it considered dangerous? How does it spread? Can it be transmitted from person to person? What are its symptoms? Here is what you need to know.

What is plague?

Plague is a serious infectious disease caused by the bacterium Yersinia pestis. The bacterium is generally found in rodents such as rats and squirrels, as well as in other small mammals and the fleas that live on them.

Humans can become infected when bitten by an infected flea. Infection can also occur through direct contact with infected animals or their tissues. When the infection affects the lungs, it can spread from an infected person to another person through respiratory droplets.

Plague caused major pandemics throughout history. The “Black Death” of the 14th century was caused by plague. However, the situation today is very different from that period. With modern laboratory testing, infection-control measures and effective antibiotics, plague can be treated successfully when detected and treated in time.

The three main types of plague

Plague mainly occurs in three forms: bubonic, septicemic and pneumonic plague.

Bubonic plague

Bubonic plague is the most common form of plague. After an infected flea bites a person, the bacteria enter the lymphatic system. The lymph nodes around the armpits, neck or groin may then become swollen and extremely painful. These swollen lymph nodes are known as “buboes.”

Other symptoms may include sudden fever, chills, headache, body aches, weakness, nausea and vomiting.

Bubonic plague generally does not spread from person to person. However, if left untreated, the infection can spread to the bloodstream or lungs.

Septicemic plague

When Yersinia pestis bacteria spread rapidly through the bloodstream, the condition is known as septicemic plague.

It can cause severe circulatory problems, damage to organs, bleeding beneath the skin, tissue damage and organ failure. Severe disruption of blood flow to the fingers, toes or other tissues can cause tissue death.

This is an extremely serious condition, and delays in treatment can be fatal.

Pneumonic plague

Pneumonic plague infects the lungs and is the most serious form of plague. It is also the main form that can spread directly from person to person.

Symptoms may include sudden fever, weakness, cough, chest pain, difficulty breathing and, in some cases, bloody sputum.

A person can become infected when they inhale respiratory droplets released by an infected person through coughing or breathing, particularly during close contact. The incubation period can be very short, and the condition can deteriorate rapidly if treatment is delayed.

However, it would be incorrect to understand pneumonic plague as a disease that spreads easily through the air among the general population in the same way as COVID-19. Person-to-person transmission is mainly associated with pneumonic plague, and close contact with respiratory droplets from an infected person is an important factor.

How dangerous is plague?

Plague is considered a serious disease. If left untreated, its fatality rate can be very high. According to the World Health Organization, untreated bubonic plague can have a fatality rate of approximately 30 to 60 percent. Septicemic and pneumonic plague can be extremely dangerous without treatment.

Pneumonic plague is particularly serious because the disease can progress rapidly. According to the WHO, if untreated, death can occur as early as 18 to 24 hours after the onset of the disease.

However, there is another important fact: plague is treatable.

If the disease is identified early and appropriate antibiotic treatment is started promptly, patients can recover. Therefore, it is incorrect to assume that “death is certain” once someone contracts plague. The key challenge is detecting the disease early and starting treatment without delay.

What are the symptoms of plague?

Symptoms vary depending on the type of plague.

Common symptoms may include sudden fever, chills or shivering, headache, body and muscle aches, extreme weakness, nausea or vomiting, and swollen and painful lymph nodes.

Pneumonic plague may cause more serious respiratory symptoms, including cough, chest pain, difficulty breathing and bloody sputum.

Because the symptoms of plague can resemble those of ordinary fever or pneumonia, the disease cannot be diagnosed based on symptoms alone.

How long after infection do symptoms appear?

According to the World Health Organization, symptoms of plague usually appear within one to seven days after infection. Symptoms of pneumonic plague may appear more quickly.

Therefore, people with a potential exposure history who suddenly develop a high fever, respiratory problems or painful swollen lymph nodes should seek medical attention and undergo appropriate testing.

How is plague diagnosed?

Laboratory testing is required to confirm plague.

Depending on the patient's condition, samples may be taken from swollen lymph nodes, blood or sputum to identify Yersinia pestis bacteria.

Therefore, people should not conclude that someone has plague based solely on symptoms, videos or unverified information circulating on social media.

Can plague be treated?

Yes. Plague is treated with antibiotics. Depending on the patient's condition, medication and supportive treatment may also be provided.

In particular, delaying treatment for pneumonic plague can be extremely dangerous. Health guidelines emphasize that when there is a strong suspicion of plague, treatment should not be unnecessarily delayed while waiting for laboratory test results.

Therefore, the most important factors in treating plague are early detection and prompt antibiotic treatment.

How does plague spread from person to person?

Bubonic plague is mainly transmitted to humans through the bite of an infected flea. Infection can also occur through direct contact with the tissues of an infected animal.

Pneumonic plague, however, can spread from an infected person to another person through respiratory droplets. Therefore, patients suspected of having pneumonic plague are isolated, and people who have been in close contact with them are monitored.

How can plague be prevented?

In areas where plague is present, it is important to avoid direct contact with infected or dead wild animals and their tissues.

People should protect themselves from flea bites, control rats and other rodents, and avoid touching animals found dead under unusual circumstances.

It is also important to avoid close contact with patients suspected of having pneumonic plague and for healthcare workers to follow appropriate infection-prevention and control measures.

Is a plague vaccine necessary?

The general public does not normally need to receive a plague vaccine. The WHO does not recommend routine plague vaccination for the general population.

Special vaccination arrangements may be considered under certain circumstances for specific high-risk groups, such as laboratory workers and healthcare personnel who are continuously exposed to the disease.

What happened in Irkutsk?

Although the incident in Irkutsk has attracted global attention to plague, no outbreak of plague has been confirmed there so far.

A 28-year-old employee of a plague research institute died of pneumonia of unknown cause, after which around 200 people who had been in contact with her were placed under medical observation.

According to Russian health authorities, none of the people who had been in contact with her were found to have plague. Some were diagnosed with other respiratory infections.

The World Health Organization has also said it has received information from Russia indicating that there are no confirmed cases of plague in Irkutsk. The WHO has assessed the current risk to the general public as low.

How much risk does Nepal face?

Following the Irkutsk incident, Nepal has also begun monitoring the situation.

Based on the available information, Nepal's Epidemiology and Disease Control Division has stated that the current risk of plague in Nepal is extremely low. The public has been urged not to panic unnecessarily and to rely only on information issued by official health authorities.

As a precautionary measure, the health desk at Tribhuvan International Airport has been placed on heightened alert.

Health authorities have also stated that the National Public Health Laboratory in Teku has the necessary facilities to test for suspected plague infections in Nepal. If a suspected case is identified, the necessary healthcare and treatment arrangements can be made.

This does not mean that Nepal is ignoring the potential risk. Rather, it indicates that the country is continuing surveillance and preparedness even though the current risk is considered low.

At present, there is no need for the general public in Nepal to panic over the Irkutsk incident.

However, anyone with a recent travel history to an area where plague is present who develops a sudden high fever, extreme weakness, painful swollen lymph nodes, severe cough or difficulty breathing should immediately contact a health facility.

Healthcare workers should be informed about the person's recent travel history, possible contact with infected animals or fleas, and any possible contact with a person suspected of having the disease.

With the assistance of news agencies.