Pneumonic plague
ICD codes: A20.2 What is the ICD Code?
Pneumonic plague is a highly contagious bacterial infectious disease. It can be spread between humans via tiny droplets in the air or may develop as a complication of bubonic plague. The plague still occurs in certain areas of Africa, Asia and America.
At a glance
- Pneumonic plague is a serious bacterial infectious disease.
- It can occur on its own (primary pneumonic plague) or following bubonic plague (secondary pneumonic plague).
- It no longer exists in Germany and Europe. However, it still occurs in certain areas of Africa, Asia and America.
- With primary pneumonic plague, infection occurs via tiny droplets in the air.
- Plague must be treated promptly with antibiotics.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
What is pneumonic plague?
The plague is a highly contagious infectious disease caused by the bacteria Yersinia pestis.
Pneumonic plague is the most serious form of plague. It can occur:
- as a disease in its own right (primary pneumonic plague)
- as a complication of bubonic plague (secondary pneumonic plague)
The illness can be cured by rapid treatment with antibiotics.
How high is the risk of infection?
Thanks to improved levels of hygiene, plague is now a disease that occurs rarely in isolated cases, primarily in tropical and subtropical regions of the world.
During outbreaks of plague, the risk of travelers becoming infected can increase. There is no risk of contracting plague in Germany.
What are infectious diseases?
The video below looks at when doctors talk about an infectious disease, which pathogens trigger infectious diseases, and how they are transmitted.
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What are the symptoms of pneumonic plague?
Pneumonic plague has an incubation period of between one and three days. The incubation period is the time between getting infection and the appearance of the first symptoms.
The illness typically starts suddenly with flu-like symptoms such as:
- fatigue
- headache
- vomiting
- fever
- chills
Additional symptoms include impaired consciousness and an enlarged liver and spleen.
The condition of an infected person deteriorates rapidly.
Respiratory problems occur, such as shortness of breath and breathing difficulties, painful coughing with sputum and chest pain. Respiratory failure and shock may occur.
In addition, other severe symptoms may occur as a result of sepsis. These include:
- circulatory collapse
- organ failure
- hemorrhages (bleeding)
- blood clotting disorder with the skin turning purple
- death of tissue in the extremities
What is sepsis?
The video below explains how sepsis is triggered. What are the symptoms and how can they be treated?
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How do people get pneumonic plague?
Pneumonic plague is caused by bacteria called Yersinia pestis.
In primary pneumonic plague, the infectious agents are spread from person to person via the inhalation of infectious respiratory droplets that are released when talking or sneezing.
The secondary form of the disease occurs when the bacteria spread to the lungs of a person already suffering from bubonic plague.
In rare cases, the bacteria can also be spread by droplet infection.
How common is bubonic plague?
A total of 3,248 cases of plague in all its forms worldwide were reported to the World Health Organization (WHO) between 2010 and 2015, with 584 infections proving fatal.
For detailed information about the regions where plague still occurs, see the article about bubonic plague.
How does pneumonic plague progress?
Pneumonic plague is the most serious form of plague. It can be cured if treated quickly with antibiotics.
If a patient cannot be treated quickly enough, the illness proves fatal within 24 hours in most cases.
How can pneumonic plague be prevented?
At present, no vaccine to prevent plague has been approved anywhere in the world. If someone comes into contact with a person with plague, an antibiotic can be administered prophylactically, i.e., on a preventive basis.
The Foreign Office (Auswärtiges Amt) has published a leaflet about plague. It is aimed at people working in and traveling to areas with plague infections.
To the leaflet
How is pneumonic plague diagnosed?
Initial indications of pneumonic plague are detected when doctors take a detailed medical history of the patient. The doctor asks the patient, for example:
- whether they have stayed in an at-risk area in recent days
- where there are currently any known plague infections in the at-risk area
- whether the patient has had any contact with people who have plague
If the doctor determines, when taking the patient history, that the patient has been exposed to an increased risk of infection and is showing typical symptoms, this corroborates the suspicion of an infection with pneumonic plague.
To enable an accurate diagnosis, samples of blood or saliva are sent for laboratory analysis using special methods to detect the pathogen directly.
How is pneumonic plague treated?
Anyone who gets pneumonic plague must be taken to hospital as quickly as possible and treated with appropriate antibiotics.
Initially, and during treatment, it is important to ensure that the drugs used are actually effective against the bacteria. This is because a number of infectious agents have now developed resistance to antibiotics.
- Auswärtiges Amt. Merkblatt für Beschäftigte und Reisende: Pest. Aufgerufen am 20.03.2023.
- European Center for Disease Prevention and Control (ECDC). Plague. Annual Epidemiologic Report for 2018.
- Robert Koch-Institut (RKI). Antworten auf häufig gestellte Fragen zu Pest. Aufgerufen am 20.03.2023.
- Robert Koch-Institut (RKI). Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2018. Stand: 1. März 2019.
- Robert Koch-Institut (RKI). Pest. RKI-Ratgeber. Aufgerufen am 20.03.2023.
- World Health Organization (WHO). Plague. Aufgerufen am 20.03.2023.
Reviewed by the German Society for Tropical Medicine, Travel Medicine and Global Health (DTG).
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