Epidemiology

Endemic in western US (as scattered cases in rural areas)

Etiology

• Pathogen: Yersinia pestis
• Reservoir: prairie dogs, squirrels, rodents
• Transmission
  • Bites by infected fleas

Pathophysiology

Clinical features

• Bubonic plague (most common)
  • Sudden onset of fever, headache, myalgias, chills, and painful swollen lymph nodes (buboes)
  • May progress to sepsis, pneumonia, and meningitis.
• Pneumonic plague
  • Signs of pneumonia
  • Rapid progression with possible respiratory failure and shock
• Septicemic plague: clinical features of sepsis, possible shock, abdominal pain

Diagnostics

Treatment