The Bubonic Plague
BY:
KARLA GARCIA
JODECI OQUENDO
LUIS RIVERA
Patient- Abigail Harris
 22 year old female reports to a local Hospital
center complaining about having chills, fever,
muscle pain, and slight swelling in her under arm.
 Patient started noticing symptoms 4 hours prior to
being admitted into the campus health center in
the school she attends. She thought she had
symptoms of a severe flu, since she traveled to her
home country recently.
Abigail Harris
 Is a student in a private law school, and is
studying to become a lawyer
 She reported a sudden death of a relative in
her country of origin south Africa, where she
also finished coming back from 2 hours
prior to being admitted.
Exam at the ER
 Patient was seen by physician at the ER.
 Was asked for medical History and a physical
exam.
 Medical history reveals she had bone problems in
her legs when she was younger, her bones were a
bit underdeveloped for her age, but relate to none
of her symptoms.
Physician
 Medical doctor.
 Primary care specialist .
 PhD in medicine.
 Training is 4 years of medical school and additional
years for residency.
 This career is designed to diagnose and treat people
with medical problems.
 They make all the decisions when it comes to their
patients.
Exams
 Vital signs a little off, not very on point
 Height: 5’3, Weight: 125, Temp: 103.2°F
 Swelling in the under arm where there’s a lymph
node.
 High fever, and doesn’t seem to decrease with
antibiotics
 The physician then looks around her body for any
open wounds that can be infected.
Lymph Nodes
 The lymph node plays a significant part in the
immune system.
 There is a type of white blood cell in the lymph node
that is an antibody, it is released into the blood and
acts as the immune system.
 When an infection is present or a virus other
immune system cells are sent to the lymph node to
prepare to eliminate the virus, causing the swelling.
 Lymph nodes are located in the neck, armpits,
throat, chest, groin, and abdomen
Exams
 Physician proceeds to examine her body for anything
out of the ordinary
 He then encounters a wound in her under arm, he
concludes it might be a “bubo” (enlargement of the
lymph gland) that is a vital sign of the bubonic
plague.
rarediseases.about.com
The “bubo”
blackdeathfacts.com
cfmsjohnson.pbworks.com
Patient translated to Intensive care
 Abigail Harris is then translated on emergency to a
different part of the hospital for immediate
treatment, she is questioned about her travels,
Family members, and home life.
 She tells the new doctor about her recent arrival
from her trip to South Africa for a family death 2
hours prior to being admitted in the health center
In the Hospital
 She also tells them she lives in a rural part of South
Africa, which makes it more likely to be exposed to
many diseases.
 Patient also recalls getting a small bug bite in the leg
where she felt pain but does not act on the pain until
she finally decided to go to the health center.
Diagnosis
 The physician then diagnoses Harris with having the
Bubonic Plague, but along with other possible
diseases.
 A rare but existent disease in foreign countries.
 The physician then refers her to an Infection Disease
Doctor, to help with full diagnosis and treatment.
 Physician also orders blood work to be done, to be
sure.
Infection Disease Specialist
 While seeking treatment at a local Hospital, the
Infection Disease Specialist conducts several tests,
and starts brainstorm immediate out treatment
options.
 Training is 3 years as a doctor of internal medicine, 4
years of medical school and 2-3 specialized training
in infectious diseases
 This career is designed to review medical data and
perform physical exams to determine the problem
Hospital Treatment
 The blood work is complete.
 The doctors are now sure she had been infected with
the Bubonic Plague and needs to seek emergency
treatment.
 The Infection Disease Doctor is now present to assist
with treatment.
 The ID Doctor also contacts an epidemiologist.
Blood work
 Up close picture to
the blood work
done.
 The cells with the
tinted substance
show the infection
http://healthland.time.com/2011/05/10/first-case-of-bubonic-plague-in-2011-appearsin-new-mexico
The Bubonic Plague
 The plague comes from infected fleas that feed on
animals.
 One of the main carries would be rat fleas, after that
fleas can travel to any other animal and it makes it
really easy to spread among humans.
 If left untreated you are more than likely to die from
the bubonic plague.
Animals that carry the disease
http://en.wikipedia.org/wiki/File:Flea_infected_with_yersinia
_pestis.jpg
http://2.bp.blogspot.com/Ar8Sm3Mknx0/TmfvMm0iQnI/AAAAAAAAB2Q/ZPPun
GL3wzM/s1600/rat.jpg
Bubonic Plague
 The disease was discovered during the early 16th
century, in Europe.
 There was huge epidemic and caused people to die
in huge masses.
 There was stories written about it, such as “The
Masque of the Red Death” by Edgar Allen Poe.
Bubonic plague
victims in a mass
grave from 1720-1721
in Martigues, France
Bubonic Plague “Black Death”
 The disease was also referred to as the “Black
Death” Killing millions of people in the blink of an
eye.
 Once infected with this disease you start to show
symptoms of it 2-6 hours after infection, in rare
cases even up to 6 days.
 The most significant symptom of the bubonic
plague is the swelling of the lymph gland called a
“bubo”, it is commonly found in the groin, but can
also occur in the armpits or neck, most likely at the
site of the infection or bite
Symptoms
 Chills
 Fever
 General ill feeling
 Headache
 Muscle pain
 Seizures
 Smooth, painful lymph gland swelling called
a ”bubo”

Pain may occur in the area before the swelling appears
Infection Transmission
 The plague comes from infected fleas that feed on
animals.
 One of the main carries would be rat fleas, after that
fleas can travel to any other animal and it makes it
really easy to spread among humans.
 You may also be exposed to the virus by cats, dogs,
and many other animals.
 If left untreated you are more than likely to die from
the bubonic plague.
Infection Treatment
 The most common antibiotics to treat the bubonic
plague would be, striptomycin, gentamicin,
doxycycline, or ciproflaxcin.
 In addition to the antibiotics, the patient must be
kept in the Hospital, with oxygen, an IV to induce
fluids into her body, and respiratory support might
be necessary, as her infection has happened hours
ago, there is no time to waste.
Streptomycin
 A drug used to treat patients with an infection
created by microorganism.
 Usually used to treat tuberculosis, another infection
brought similar to the plague.
 This drug is used to treat severe cases, for other non
high risk infections this drug would not be
commonly prescribed.
Gentamicin
 This drug is mainly to fight bacteria in the body,
brought on by infections.
 Only for severe or serious infections.
 This is usually prescribed for a certain amount of
time, and should not be taken off the regulated
schedule.
 Indications:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or
IM every 8 hours or 5 to 7 mg/kg IV every 24 hours.
Doxycycline
 Doxycycline is a medication prescribed to treat
bacterial infections
 Works to prevent the growth and spread of the
bacteria
 It comes as a tablet, a syrup, and a liquid all taken
orally
 Doses depend upon doctor’s request
Ciproflaxcin
 Ciprofloxacin is used to treat or prevent certain
infections caused by bacteria
 Works by killing bacteria that causes the infection
 It comes as a tablet, a liquid, and an extendedrelease tablet to be taken orally
 Doses and brands depend upon doctor’s request
Goal of treatment
 The goal, at this point for the patient would be to
save her life, and prevent the evolving of the disease
as it can become worse and harder to treat.
 Prevent spread amongst people she knows
 Develop better treatments in case another patient
with the plague shows up.
Prevention/ Control
 When traveling to foreign places, be informed.
 Also be aware of any animals that may bite you, if so
seek medical attention immediately.
 Stay away from rodents and other animals that you
are not familiar with when traveling.
 A vaccination is also available, but might not be
100% effective to prevent this infection.
Epidemiologist
 An epidemiologist is a doctor that investigates the
cause of the disease and other health problems to
control and prevent them from spreading
 Education requirements include a master’s degree
from a school of public health and a Ph.D. or
medical degree
Epidemiologist’s results
 Her family lives in a rural part of South Africa.
 They have many animals and are exposed to rodents




everyday.
When she went to visit, due to the death of a loved
one she slept in a low quality hotel to save money.
Particularly exposed to rodents and other animals.
This is more than likely where she retrieved the
infection.
A small flea could have bit her as she was leaving the
country to board a plane back the U.S.
The Plague
 There are two more types of the Plague.
 Pneumonic Plague- infection of the lungs
 Symptoms:
Cough
 Difficulty breathing
 Fever
 Frothy, bloody sputum
 Pain in the chest when you breathe deeply
 Severe cough

The Plague
 Septicemic Plague- infection of the
blood.

Symptoms:

Abdominal pain
Bleeding due to blood clotting problems
Diarrhea
Fever
Nausea
Vomiting





 Death can occur before the symptoms even show.
Abigail after
 After going under treatment
for the bubonic plague, the
patient has a made a full
recovery.
 The medication used to treat
her infection have worked as
projected and she is now rid
of the infection in her body.
 Graduated from law school.
 Plans to open a firm.
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