Pest

• Yersin, 1894
• Kitasato, 1894

Pestis, pestilentia, black death.

Notifiable infectious disease caused by the aerobic, gram-negative, "safety needle" bacterium.

• Millions of plague deaths occurred in the Middle Ages
• Endemically, it still occurs in Africa, Southeast Asia, India and on Indian reservations in the USA

• Yersinia pestis is ingested by fleas as part of the sucking act and is ultimately transmitted to rodents and humans. The plague manifests itself cutaneously (bubonic plague)
in 90%

• Pathogen: Yersinia pestis
• Transmission: flea bites
• Incubation period: 1-6 days

Bubonic plague (bubonic plague):

• 90% of all plague cases
• Reduced general condition, febrile temperatures, myalgias, arthralgias, tachycardia, delirium
• Small papules or papulovesicles appear in the area of the portal of entry, which are usually overlooked
• In the lymphatic drainage area, there is locoregional lymph node adenopathy
• In bacteraemia, there is petechiae, ecchymosis, disseminated intravascular coagulopathy, sepsis and pulmonary involvement (black death)

Pneumonic plague: dyspnoea, haemoptysis, cyanosis

• Anamnesis (travel anamnesis)
• Clinical
• Detection of pathogens: Bact. smear (sputum, bubones), blood culture
• Serological antibody detection

• Bubonic plague: untreated 50-90% lethality, treated 10-20%.
• Pneumonic plague: untreated 100% lethality, treated 50%.

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