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A Gripping Fear

by Dr Golam Nabi
SURAT, a port city of western India is horrifying the world population. The name Plague was almost disappearing from our mind After decades it comes again to hammer our consciousness occouring in a densely populated country like India Prior to §urat. outbreaks have predominantly been in Vietnam and Easl Africa with sporadic cases elsewhere around the globe. Epidemic of plague. known as the black death have attacked man since ancient times. At that time i here were not much treatment available to fight against plague. But in this modern world where science has done wonders and many Impossible things have been achieved, ft S very unfortunate that within a couple of weeks several hundreds of people have died in Surat.
What Is actually plague? What is its symptoms? How does it spread? Is there any treatment available? Is there any prophylaxis? If we are fully aware of these things, we will possibly be protected from the menace of the deadly disease — plague. Though Surat Is several thousand miles away from Bangladesh, cases have also been identified in Delhi and Calcutta last week. So we should be careful and must take precautions.
Plague, is principally a disease of rodents in the wild. The causative organism is yersina pesos' — is a small gram negative bacillus. It spreads through rodents by their fleas and If domestic rodent becomes Infected then the infected fleas may bite man and man may get Infected by the organisms Inoculated through the skin. Later, the Infected man can spread the disease to others by droplets
(snvc -iu- coughing, breadline'
Tin re are three types of plague namely: "Bubonic plague'. Septicaemic plague' and "Pneumonic Plague".
BUBONIC PLAGUE: The most commonest form of thez disease is the Bubonic one. The person infected with the plague organisms presents suddenly with high fever, rigour, severe headache, bodyache. skin becomes dry. pulse liecomes rapid, blood pressure falls, sometimes patients be-come confused and talks irrel-< -. iilllv
SYSTEMIC PLAGUE: Sometimes the infected person does not exhibit a bubo but deteroriate rapidly, have'se vere headache, pain in Ihe neck, high rise in body temperature with other sign and symptoms of meningitis.
PNEUMONIC PLAGUE: Infected person may not have bubo but suddenly becomes ill with cough, difficulty In breathing, fever followed by copious amount of blood stained frothy sputum which is highly infective. Patient becomes cyanosed and soon dies.
Early diagnosis is essential, culture of the sputum, blood or the aspirate from the bubo can demonstrate the charecteristlc organisms. After the diagnosis treatment should start immediately. 'Streptomycin' is given by intramascular or intravenous injections at a dally dose of 30 mg/kg body weight every 6-12 hours according to the .severity of the disease for 10 days, or Tetracycline' 10 mg/kg body weight every 6
hours orally or ini ravenously for lO days.
Now the prime job is the public awareness about the disease. Government should take the measures on a priority basis specially around the boarder town and villages by miking and postering the signs and symptoms of the disease. The state media like TV/Radio has a great role to play and should start immediately to aware people about plague'. Rats should be controlled by insecticides containing 1.5% Dieldrin or 2% Aldrin applied to floor and blowrj into rat litiles. kill all the fleas and remain alert for 9-12 weeks at least.
People specially in the rural areas should be careful, as the incubation period Is 3-6 days, suspected victim who has got sudden high fever, headache, cough, difficulty in breathing, swelling of the groin or a history of rat bite or fleas bite — must immediately be rushed to a doctor or to the health center. Patients should be isolated from others, attendants must wear gown, masks, gloves and should take bath properly after nurshing the patient. Family members, and attendants of an infected person must take Cap. Tetracycline' 2 gm daily (8 capsules containing 250 mg) in divided doses for a
week. Pregnant women and children should not take Tetracycline without the doctor's advice, they may take Sulphonamide 3-6 gm daily tn divided doses for a week as prophylactic measures.