The mortality rate for untreated plague has ranged from 66% to 93%; however, in the antibiotic era, mortality has been reduced to approximately 16% (4). Prompt treatment with antimicrobials such as aminoglycosides, fluoroquinolones, or doxycycline greatly improves outcome (4).
Persons engaging in outdoor activities in areas where plague is endemic should wear long pants when possible and use insect repellent on clothing and skin. Persons also should avoid direct contact with ill or dead animals and never feed squirrels, chipmunks, or other rodents. In addition, pet owners should regularly use flea control products on their pets and consult a veterinarian if their pet is ill. Rodent habitat can be reduced around the home by removing brush, clutter, and potential rodent food sources such as garbage or pet food. Additional information on prevention of plague is available at
Plague M. D. is a medieval medicine simulator.Become a quack doctor stuck in a backwater village in the 16th century. Your task is to diagnose and cure the patient using the available tools, ingredients, recipes and books. This is a difficult game against time, misdiagnosis and procrastination can lead you to the stake, and every choice has consequences.Well, what can you do? At first, your methods are scarce - drain blood, amputate a rotten finger. But over time, you become increasingly sophisticated, learning therapeutic treatments and surgical skills. Eventually, you face the horror of black death and put on a plague doctor mask.
Kennedy and Maduh worked out of the same facility and are the only two correctional officers in the state to have died from COVID-19. Their deaths underscore the dangers faced by officers and inmates as the state grapples with a virus that has plagued the corrections system for seven months and killed at least 11 inmates.
Well, what can you do? At first, your methods are scarce - drain blood, amputate a rotten finger. But over time, you become increasingly sophisticated, learning therapeutic treatments and surgical skills. Eventually, you face the horror of black death and put on a plague doctor mask.
The infection travels rapidly to the lymph nodes, where white blood cells are produced. The resulting reaction from the lymph nodes is a rapid multiplication of white cells, abnormal fluid build up with swelling, and possible skin breakage. Dogs infected with plague will experience fever, inflammation, and excessive pain due to the lymph nodes being chronically swollen.
There are three forms of plague: bubonic plague, pneumonic plague, and septicemic plague. Symptoms associated with bubonic plague will include painfully swollen lymph nodes, fever, inflammation, depression, vomiting, dehydration, diarrhea, enlarged tonsils, and anorexia. The head and neck area will swell considerably, and should the dog survive, its lymph nodes may abscess and then rupture and drain. Other symptoms include discharge from the eyes, mouth ulcers, and a loss of appetite, with visible weight loss being evident. Coma may follow.
The normal incubation period for bubonic plague is between two and seven days after the dog has been bitten. In the case of pneumonic plague, a lung infection will occur; and with septicemic plague, the same symptoms as bubonic plague will appear, along with systemic infection of the blood.
If the home is heavily infested with fleas, or if the homeowner resides near a wildlife habitat, where the dog is exposed to rodents, this could put the dog at a higher risk of contracting the plague. Garbage, woodpiles, and food sources can also be outlets for transmission of this disease.
Your veterinarian will run a full diagnostic evaluation on the dog, including blood samples, culture samples of fluids, and kidney and liver testing, in order to establish a definitive diagnosis of this disease. A swollen lymphatic system is a clear indication that infection is present and blood tests will show the level of white blood cells present, amongst other things, further aiding in identifying the presence of plague bacteria.
Your dog will require hospitalization to treat the more severe symptoms of plague, and will be given a full course of antibiotics. Dogs that are weakened and dehydrated, will require an intravenous drip to assist in rehydration. Flea treatment will also be required. The incidence of mortality is high for dogs that are not treated early and effectively.
Ongoing flea control and management of rodents is a must. There is no home management plan for this disease, and all cases of suspected infection should be reported to your veterinarian immediately. However, maintaining a flea free home and keeping rubbish, food, and woodpiles to a minimum will help greatly in reducing the risk of plague infection.
When travelling to areas where the plague bacteria may be present, it is wise to make sure your dog is kept on a leash or in an enclosed environment at all times so that exposure to wild rodents or fleas that may be carrying this disease is limited.
Both scholars doubt previous theories that the Plague of Athens was caused by ebola, bubonic plague, dengue fever, influenza or measles because the symptoms described in ancient historical records do not match those diseases. Despite evidence that it was typhus fever spread either by lice or by air, Dr. Durack and Dr. Littman do not rule out the possibility the Plague of Athens was caused by something else.
Dr. Durack explains: "The Plague of Athens is a medical and historical classic, which has fascinated doctors and historians for centuries. Even if we can never be absolutely sure what caused the plague, the story is still relevant today because we continue to experience the outbreak of new emerging infectious diseases. The Plague of Athens can give us insights on how to respond to AIDS, Legionnaire's Disease, drug-resistant organisms, toxic shock, hantavirus infections and other emerging diseases."
Dr. Littman elaborates: "Plagues are a recurring phenomenon in human history and they are something that is a constant fear of mankind -- being struck by an unknown disease. This plague was of tremendous importance because it signaled the downfall of the Golden Age of Athens, caused the death of Pericles and 25 percent of the population, weakened Athens at the beginning of its 27-year war with Sparta and became the first medical outbreak so thoroughly recorded by historians."
Thanks to treatment and prevention, the plague is rare now. Only a few thousand people around the world get it each year. Most of the cases are in Africa (especially the Democratic Republic of Congo and Madagascar), India, and Peru.
After people catch the plague, the symptoms start 1-6 days later. You feel very sick and weak and may have a fever, chills, and headaches. Other symptoms depend on the three main kinds of plague:
Bubonic plague. This is the most common type. It causes buboes, which are very swollen and painful lymph nodes under the arms, in the neck, or in the groin. Without treatment, the bacteria can spread to other parts of the body.
The world in the Lapse of plague will use a familiar medieval setting, where medical facilities or knowledge have not yet developed, and the player must take advantage of everything to continue the business and save the lives of the patients. However, the game has an impressive and classic style, with a point-n-click style for players to freely explore the city or interact with the characters.
Based on the plot in Lapse of plague, the player must construct various processes to save entire cities from potential dangers from various sources. At that time, people did not yet develop techniques and technology for medicine.
In addition to taking action and saving lives in the Lapse of plague, players can change the way people think or interact through special actions. That includes unique encounters while moving around, and each choice will leave an unexpected outcome, creating attraction and curiosity for players. Besides the unexpected encounters, players also have to deal with corrupt ideologies or people who intend to destroy their entire progress the entire time.
Lapse of plague is a perfect game in every respect in reimagining the complexity and effort of medieval doctors. Moreover, it stimulates all famous pandemics to bring players the best quintessence and experience throughout the gameplay.
And then cometh the plague. Despite the randomization to ensure balance of prognostic factors between the arms at the time of randomization, COVID-19 provided an unanticipated imbalance postrandomization that impacted umbralisib/ublituximab disproportionately to chlorambucil/obinutuzumab. At the first ad hoc, FDA-mandated survival analysis, there were more deaths in the umbralisib/ublituximab arm resulting in the unfavorable hazard ratio. It is noteworthy, however, that the chlorambucil/obinutuzumab therapy lasted for 6 months, and all patients were off therapy at least 2 years prior to the start of the pandemic. In contrast, both drugs in umbralisib/ublituximab were administered until disease progression or intolerance, with about 40% of patients on active treatment with umbralisib/ublituximab at the start of the pandemic. The median follow-up in the umbralisib/ublituximab arm was 21.1 months compared with 5.1 months with chlorambucil/obinutuzumab, which resulted in marked differences in the collection of adverse events, as all data collection across both arms, by design, was terminated 30 days after completion of therapy.
Whether we like it or not, the challenges that clinical research has faced in the past are now magnified by COVID-19. Close interaction among clinical researchers, pharmaceutical sponsors, regulatory agencies, and patient representatives will be essential to develop strategies that will be safe and effective in the coming years of the plague. 041b061a72