Sunday, July 4, 2010

Plague Plagueing the World

A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Sat 2 Jul 2010
Source: JSS News [machine trans., edited]

According to the Syrian opposition in exile, the Syrian president, who
is visiting Latin America, has ordered the shutdown of all Syrian
military exercises due to a plague that currently affects a large
number of military, especially conscripts doing their training.
Drinking water and food in the bases and the current heat wave are the
cause of the epidemic.

Touched by a terrible drought, this epidemic (which reminds us of the
Middle Ages) could cause extensive damage to elements of the Syrian
army in the coming weeks. Military sources have completely rejected
the possibility of outside intervention that could be causing the

Syria is currently facing the worst drought in 40 years. Hundreds of
thousands of people are experiencing food shortages; peasants have
been decimated, and many people are fleeing the country. Already,
nearly 60 000 small livestock owners have lost all their animals, and
50 000 others have lost 50-60 percent of their cattle.

If the early symptoms of plague have occurred in the military (the
Syrian army has 215 000 men, plus 300 000 reservists), it is probable
that the soldiers will spread the disease, especially with the
approach of Ramadan [11 Aug-9 Sep 2010] when a great number of
soldiers return to their villages.

The last plague epidemic in Europe was in 1910.

[Byline: Ftouh Souhail]

Communicated by:

[Plague is a bacterial infection of humans and other animals, caused
by the Gram-negative bacillus _Yersinia pestis_. Three major plague
pandemics have been recorded in human history: the 1st in the 6th
century; the 2nd in the 14th century, which killed up to 1/3rd of the
European population; and the 3rd at the end of the 19th century
followed the spread of infection from China. Sporadic cases and
limited outbreaks of plague continue occur currently in various
countries throughout the world. However, during the winter of 1910 to
1911, an explosive epidemic of primary pneumonic plague raged in
Manchuria and northern China and killed more than 50 000 people
[Levison ME. Lessons learned from history on mode of transmission for
control of pneumonic plague. Curr Infect Dis Reports. 2000; 2 (4):

In the United States, the last urban plague epidemic occurred in Los
Angeles in 1924-25. Since then, human plague in the United States has
occurred as mostly scattered cases in rural areas (an average of 10 to
15 persons each year); more than 90 percent of human plague occurs in
the Southwest, especially New Mexico, Arizona, California, and
Colorado. Plague bacillus has also been listed among possible
bioterrorism agents.

Wild rodents in certain areas around the world are infected with the
plague bacillus. The organism is transmitted among these animals by
the bite of infected fleas. Plague may spill over from wild rodents
into the peridomestic rodent populations and their fleas, which bring
plague into human contact. The usual mode of transmission for bubonic
plague is the bite of an infected rat flea. Direct contacts with
tissue or bodily fluids of an infected animal or inhaling infectious
airborne droplets of respiratory secretions are other modes of

Outbreaks of plague are most likely to occur when rats live closely
with humans, usually in poverty-stricken areas with poor sanitation,
and when humans share habitat with wild rodents infected with plague

Plague occurs mainly in 3 clinical forms: Bubonic plague, with
enlarged, tender lymph nodes (buboes), fever, chills and prostration;
septicemic plague, with fever, chills, prostration, shock and bleeding
into skin and other organs; and pneumonic plague, with fever, chills,
cough, and difficulty breathing. Septicemic plague may occur with or
without bubonic plague. Pneumonic plague may either be due to a
secondary spread through the bloodstream of advanced bubonic plague
(secondary pneumonic plague), or due to inhalation of aerosolized
infectious droplets (primary pneumonic plague). Pharyngeal plague and
plague meningitis are less common forms. Rapid diagnosis and treatment
is essential to reduce complications and fatality.

As noted by ProMED moderator JW, plague has occurred in this region
However, the news release above fails to detail microbiologic
confirmation, clinical manifestations and epidemiology of this current
outbreak among the Syrian military. Curiously, the news release above
says that drinking water, food, and a heat wave are causes of the
epidemic, but if this outbreak were plague due to _Y. pestis_, these
would be unlikely "causes," unless in some way they increased contact
between humans, infected rodents and rat fleas.

Pictures related to plague can be found at
The HealthMap/ProMED-mail interactive map of Syria can be seen at

- Mod.ML]

[see also:
Plague, bubonic, fatal - China: (GS) 20100618.2052
Plague, pneumonic - China (06): (QH), WHO 20090811.2870
Plague, pneumonic - China: (QH), RFI 20090801.2702
Plague, human - Mongolia: (BO), RFI 20090612.2177
Plague, bubonic - Mongolia (Gobisumber) 20070924.3163
Plague, human, fatal - Mongolia (Hovsgol) (03) 20070810.2602
Plague, human, fatal - Mongolia (Hovsgol) 20070807.2567
Plague, rodents - Russia (Volgograd, Astrakhan): susp. 20070128.0368
Plague, camels - Uzbekistan, Kazakhstan, Turkmenistan: susp. 20050212.0479
Plague - China (Tibet) 20050626.1798 20040901.2429
Plague - Turkmenistan (Dashoguz): susp (02) 20040707.1820
Plague - Turkmenistan (Dashoguz): susp 20040706.1811
Plague warning - Russia: RFI 20040427.1178
Plague - Mongolia 20030908.2255
Plague, bubonic - Kazakhstan (Kzyl-Orda) 20030822.2119
Plague - Kazakhstan (Mangistausk): suspected 20030801.1881
Plague - Mongolia 20020919.5361
Plague, bubonic - Mongolia (Central): correction 20010904.2115
Plague, bubonic - Mongolia (Central) 20010808.1871
Plague, bubonic - Mongolia & China: background (03) 20000924.1645
Plague, bubonic - Mongolia & China: background (02) 20000920.1620
Plague, bubonic - Mongolia & China: Background 20000802.1290
Plague, bubonic, marmots - Mongolia: RFI 20000801.1274
Plague, bubonic - Kazakhstan (05) 19990817.1418
Plague, bubonic - Kazakhstan 19990802.1322
Plague, marmots - Kyrgyzstan (Dzhetyoguz) 19980811.1572]

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