Date: 2009-09-20 00:56:38
Much more a scare: pneumonic plague www.bangkokpost.com/… KILLER AROUND THE CORNER Recent outbreak of pneumonic plague in China has alarm bells ringing Writer: By ANJIRA ASSAVANONDA Published: 10/09/2009 at 12:00 AM Newspaper section: Mylife After the outbreak of bird flu and the deadly H1N1 virus, parts of the world have come under the threat of pneumonic plague, a disease that in the past was a dreadful killer. As of Aug 6, the plague had reportedly killed three people in north-western China, which had 12 confirmed cases, and the authorities had sealed off Ziketan, an infected town of more than 10,000 people. The World Health Organisation (WHO) announced that pneumonic plague is the most virulent and least common form of plague. It is caused by the same bacteria as the bubonic plague, which caused the Black Death during the Middle Ages, killing an estimated 25 million people in Europe. The report sparked fears over whether the disease will become another pandemic threatening the world community, and whether the micro-organism that causes the plague would develop into a new strain that is hard to control. Thailand, which has a close trading and tourism relationship with China, should also keep a close watch on the disease, so it can properly handle the situation if an outbreak occurs. Dr Surachai Rungtanapirom, of Bangkok Hospital, has some important information for the public to better understand and prepare for the plague. What is pneumonic plague? The plague is a zoonotic disease caused by the bacteria yersinia pestis that mostly circulates among rodents and their fleas. Bangkok authority rounded up rats at Klong Toey port for testing after the outbreak of pneumonic plague in China. When humans are bitten by the infected fleas, the bacteria can cause three forms of plague, depending on the route of infection: Bubonic (through the lymphatic system), Septicaemic (through the bloodstream), and Pneumonic plague (through the lungs). Bubonic plague is the most common form, accounting for 80% of plague cases. It is contracted from the bite of infected fleas. The bacteria enters the skin and travels through the lymphatic system, causing the lymph nodes to be inflamed. Septicaemic plague accounts for 15% of plague cases, and occurs when the infection spreads directly through the bloodstream. Pneumonic plague, the one that has recently emerged in China, is the most virulent and least common form of the disease. While bubonic plague is usually transmitted by flea bites, pneumonic plague is easier to contract, through inhaling droplets from an infected person or animal, and can be transmitted from human to human. It may also occur if a person with bubonic or septicaemic plague is left untreated and the bacteria spreads to the lungs. How can it be transmitted? Commonly, the transmission occurs among rodent animals, such as rats, chipmunks, squirrels, and wild rabbits. These animals have fleas, and when humans are bitten by the infected fleas, they can contract the disease. When the host animals die, the hungry fleas will seek other sources of blood to survive. People and animals that visit places where rodents have recently died from plague risk getting it from flea bites. Dr Surachai Rungtanapirom Plague transmission can also occur through direct contact with infected tissue or bodily fluids, such as when handling infected rodents. Besides rodents, house cats and dogs are also susceptible to the plague, and can bring plague-infected fleas into the home. These infected pets can directly transmit plague to people who handle or care for them. It’s also possible to become infected from a bite or scratch from a cat or dog. The other way of transmission is by inhaling droplets expelled by the coughs of infected people or animals. Normally, yersinia pestis bacteria is easily destroyed by sunlight and drying. Even so, when expelled in droplets, it can survive for up to one hour, and go as far as 50km. “You’ll see the difference when comparing this to the transmission of the H1N1 flu virus. The swine flu is contracted through eye, nose and mouth tissues. If you touch something with flu viruses on it and then touch your mouth or nose, you’ll be infected. But the plague bacteria stays in the droplets when patients cough or sneeze, and you’ll be infected once you inhale those droplets. However, note that it’s not airborne, meaning the germ is not in the breath of infected persons,” Dr Surachai said. What are the symptoms? When a person becomes infected, plague bacteria will multiply within the body. In case of pneumonic plague, this occurs in the lungs. From the time of infection, it takes one to three days for symptoms to appear. The first signs of pneumonic plague include instant fever, severe headache, weakness and quick development of pneumonia with shortness of breath, chest pain, and coughing within 24 hours. Sometimes the phlegm turns into a rusty or bloody colour. As the symptoms worsen, patients can have trouble breathing, cough up blood, experience respiratory failure and shock. If not treated, patients may die in 48 hours. High fever, body pain, and loss of appetite could be indications of the plague. Some patients may have traces of flea bites on their bodies. If you have any lymphatic symptoms, that could also be a sign of plague. Go to the doctor as soon as possible. The treatment When a plague infection is suspected, the person is often hospitalised and placed in isolation for at least a week. Early treatment is crucial to reduce the chances of death. The treatment typically involves antibiotics, such as streptomycin, gentamicin, tetracyclines and chloramphenicol, which should be administered within 24-48 hours of the onset of symptoms, otherwise, the chance of fatality will be high. It is also important to identify and examine people who have been in close contact with an infected person. “Pneumonic plague has a high fatality rate. If left untreated, the patients can die within 24 hours, but it is also curable if diagnosed in time,” Dr Surachai said. He added that with timely and proper treatment, patients can recover within a week. […] At 17:56 19.09.2009, you wrote: Yep, you’ll never believe it… Monkey Malaria!! I’ve highlighted what I think might be a clue… www.sciencedaily.com… Web address: www.sciencedaily.com…
090909103004.htm Emerging New Monkey Malaria Species Potential Deadly In Humans ScienceDaily (Sep. 9, 2009) Researchers in Malaysia have identified key laboratory and clinical features of an emerging new form of malaria infection. The research, funded by the Wellcome Trust, confirms the potentially deadly nature of the disease. Malaria kills more than a million people each year. It is caused by malaria parasites, which are injected into the bloodstream by infected mosquitoes. Of the four species of malaria that commonly cause disease in humans, Plasmodium falciparum, found most commonly in Africa, is the most deadly. P. malariae, found in tropical and sub-tropical regions across the globe, has symptoms that are usually less serious. Recently, researchers at the University Malaysia Sarawak, led by Professors Balbir Singh and Janet Cox-Singh, showed that P. knowlesi, a malaria parasite previously thought to mainly infect only monkeys in particular long-tailed and pig-tailed macaques found in the rainforests of Southeast Asia was widespread amongst humans in Malaysia. Subsequent reports in neighbouring Southeast Asian countries have led to the recognition of P. knowlesi as the fifth cause of malaria in humans. Now, in a study published in the journal Clinical Infectious Diseases, Professors Singh and Cox-Singh, together with colleagues from University Malaysia Sarawak, Kapit Hospital and the University of Western Australia, have published the first detailed prospective study of the clinical and laboratory features of human P. knowlesi infections. “P. knowlesi malaria can easily be confused with P. malariae since these two parasites look similar by microscopy, but the latter causes a benign form of malaria,” says Professor Singh. “In fact, because the P. knowlesi parasites reproduce every twenty four hours in the blood, the disease can be potentially fatal, so early diagnosis and appropriate treatment is essential. Understanding the most common features of the disease will be important in helping make this diagnosis and in planning appropriate clinical management.” The researchers initially recruited over 150 patients admitted to Kapit Hospital in Sarawak, Malaysian Borneo, between July 2006 and January 2008 who had tested positive with a blood film slide for Plasmodium species. Using molecular detection methods, P. knowlesi was found to be by far the most common infection amongst these patients, accounting for over two-thirds of all cases. As with other types of malaria in humans, P. knowlesi infections resulted in a wide spectrum of disease. Most cases of infection were uncomplicated and easily treated with chloroquine and primaquine, two commonly used anti-malarial drugs. However, around one in ten patients had developed complications and two died. Complications included breathing difficulties and kidney problems (including kidney failure in a small number of cases), which are also common in severe P. falciparum cases. Although the researchers saw a case fatality rate of just under 2%, which makes P. knowlesi malaria as deadly as P. falciparum malaria, they stress that an accurate fatality rate is hard to determine given the relatively small number of cases studied so far.