Classification: ICD-9 020; ICD-10 A20
Syndromes and synonyms: Pestis, pest, bubonic plague, pneumonic plague, black plague, black death.
Agent: Yersinia pestis, a Gram-negative bacillus. Y. pestis is considered a potential biological warfare agent.
Reservoir: Rodents, principally rats and sylvatic ground squirrels: marmots, susliks, and prairie dogs. Rabbits, camels, carnivores, and domestic cats may also be infected. Cats can also develop pneumonic plague. The desert regions of Central Asia contain endemic plague foci where the great gerbil is the main host.
Vector: Fleas, especially the rat flea (Xenopsylla cheopis) and possibly human flea (Pulex irritans).
Transmission: By flea bite for the bubonic form, by the respiratory route for the pneumonic form; handling carcasses or eating meat of infected animals. Person-to-person transmission occurs through the bite of fleas (bubonic form) or respiratory droplets (pneumonic form).
Cycle: There are different cycles, including a sylvatic rodent–flea cycle, a commensal rodent–flea cycle, and a cycle of pneumonic transmission in humans. Y. pestis
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