Ten mistakes.
- "Plague is history." It is a disease of wild rodents that still reaches people every year.
- "Plague is a death sentence." It is a bacterial infection that antibiotics cure when they are started early.
- "It is only flu. I will see how I feel on Monday." With plague a day is the difference. Sudden fever after an exposure means a doctor today.
- "I will take the antibiotics I have at home." The wrong medicine or the wrong dose does not cure plague; it hides it.
- "I will not mention the trip, or the animal." The history of exposure is what makes a doctor think of plague at all.
- "There are dead rats. I will throw them out and put down poison." Report them. Do not touch them with bare hands. Fleas first, rodents second.
- "I will just wash the body myself." The dead can infect those who prepare them.
- "A mask protects me from bubonic plague." Bubonic plague comes from a flea. Masks belong to the pneumonic form.
- "There is a vaccine; I will get it before the trip." There is none for the public.
- "Everything in the house has to be disinfected." The bacterium is fragile. Deal with the fleas, and with anything soiled.
The numbers.
- Incubation: 1 to 7 days overall. Bubonic usually 2 to 6 days. Pneumonic 1 to 3 days, sometimes less than 24 hours.
- Doctors count back 10 days when they ask about exposure.
- Pneumonic plague: treatment within 24 hours of the first symptoms.
- A patient with pneumonic plague is contagious from the first symptom until 48 hours of effective antibiotics.
- Close contact: within 2 metres.
- Preventive antibiotics after an exposure: 7 days.
- Treatment: 10 to 14 days.
The signs.
- Every form: a sudden high fever, chills, headache, weakness.
- Bubonic: a very painful swollen node in the groin, the armpit or the neck.
- Pneumonic: a cough, chest pain, shortness of breath, blood in the sputum — worse by the hour.
- Septicaemic: bleeding into the skin; fingers, toes or the nose turning black.
What to do.
- Sudden fever after an exposure: medical help at once. 112 across the European Union; the local emergency number elsewhere.
- Say where you have been and what you touched.
- If you are coughing: a mask, and 2 metres.
- No antibiotics of your own. Do not squeeze the swelling.
- If you were close to a patient: tell the health service, and take the preventive course you are given.
What protects.
- Against fleas: repellent, covered legs, flea control for pets.
- Against animals: hands off the dead and the sick; gloves for skinning.
- Against rodents: food shut away, holes sealed, rubbish covered.
- Against the cough: distance, a mask on the sick person, fresh air.
One sentence to keep. Plague is rare, it is fast, and it is curable — and the only part of that which depends on you is how soon you ask for help.
Source. The lessons of this course, and the documents they cite: the fact sheet, the 2024 manual and the questions and answers on plague of the World Health Organization (WHO), https://www.who.int/health-topics/plague ; the plague pages of the United States Centers for Disease Control and Prevention, https://www.cdc.gov/plague/ ; the European Centre for Disease Prevention and Control, https://www.ecdc.europa.eu/en/plague/facts
What this is not. Reading, not medical advice. In an emergency follow the instructions of the health authority and the emergency services where you are.