THE BLACK DEATH

1. Presented by :Arif Khan
Group 4th
Course 5th

2.  It was known as the "Black Death" during the
fourteenth century, causing an estimated 50
million deaths.
 Plague is caused by the bacteria Yersinia
Pestis( Enterobacteriaceae), a zoonotic
bacteria, usually found in small animals and
their fleas.
 People infected with plague usually develop
“flu-like” symptoms after an incubation
period of 3-7 days.
Bubonic plague

4.  We now know that the most common form
of the Black Death was the BUBONIC
PLAGUE! This disease was spread by fleas
which lived on the black rat. The fleas
sucked the rat’s blood which contained the
plague germs. When the rat died the fleas
jumped on to humans and passed on the
deadly disease.

7.  The most infamous symptom of bubonic plague is
an infection of the lymph glands (lymphadenitis),
known as buboes, which become swollen and
painful. 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.
 Buboes associated with the bubonic plague are
commonly found in the armpits, upper femoral,
groin and neck region. Acral gangrene (i.e., of the
fingers, toes, lips and nose) is another common
symptom.

8.  Bubonic plague symptoms appear suddenly, usually
2–5 days after exposure to the bacteria. Symptoms
include:
 Gangrene of the extremities such as toes, fingers,
lips and tip of the nose.[6]
 Chills
 General ill feeling (malaise)
 High fever (39 °C; 102 °F)
 Muscle cramps[7]
 Seizures
 Smooth, painful lymph gland swelling called a bubo,
commonly found in the groin, but may occur in the
armpits or neck, most often at the site of the initial
infection (bite or scratch)
 Pain may occur in the area before the swelling
appears
 Skin color changes to a pink hue in some very
extreme cases

9.  Other symptoms include heavy breathing,
continuous vomiting of blood (hematemesis),
aching limbs, coughing, and extreme pain. The
pain is usually caused by the decay or
decomposition of the skin while the person is
still alive. Additional symptoms include extreme
fatigue, gastrointestinal problems, lenticulae
(black dots scattered throughout the body),
delirium, and coma.

10.  Laboratory Studies
Leukocytosis with a predominance of neutrophils is observed, and
the degree of leukocytosis is proportional to the severity of illness.
Peripheral blood smear shows toxic granulations and Dohle
bodies.
Thrombocytopenia is common, and levels of fibrin degradation
products may be elevated.
Serum transaminase and bilirubin levels may be elevated.
Proteinuria may be present, and renal function test findings may
be abnormal.
Hypoglycemia may be observed.
Twenty-seven percent to 96% of blood cultures are positive for Y
pestis in patients with bubonic plague and septicemic plague.

13.  Nuclear imaging may help localize areas of
lymphadenitis and meningeal inflammation.

14.  Several classes of antibiotics are effective in treating
bubonicplague . These
include aminoglycosides suchas 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.