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Types

Depending on the symptoms and the route of infection, plague appears in several forms, classified by the WHO with different ICD-10 codes:
Main diseaseA20) Plague (Pestis). Infections caused by Yersinia pestis.FormsA20.0) Bubonic plague (Pestis bubonica) occurs when Yersinia pestis causes an inflammation of the lymph nodes, making them tender and swollen (from lat. bubo = bump). This is the most common form of plague.(A20.1) Cellulocutaneous plague (Pestis cellulocutanea) is a very unusual form, with Yersinia pestis causing a skin infection.(A20.2) Pneumonic plague or pulmonic plague (Pestis pneumonica) occurs when the lungs are infected by Yersinia pestis. The second most common form of plague. It may be a secondary infection, caused by bacteria spreading from the lymph nodes and reaching the lungs, but can also exist on its own, caused by inhalation of airborne bacteria.(A20.3) Meningeal plague or plague meningitis (Pestis meningealis) looks like meningitis at the outset. It is most common in children and is usually the end result of ineffective treatment for other forms of plague. Unusual.(A20.?) Pharyngeal plague occurs when Yersinia pestis is consumed, often through food. It can resemble tonsillitis. Very rare form.(A20.7) Septicemic plague (Pestis septic(h)aemica) occurs when Yersinia pestis multiply in the blood. The third most common form. It is usually associated with hunting and skinning of animals, but can also occur secondary to bubonic and pneumonic plague.(A20.8) Other forms of plague (Aliae formae pestis) include the milder forms abortive plague, asymptomatic plague and pestis minor, all three often resulting only in a mild fever and light swelling of the lymph glands, usually resolved in approximately a week if appropriate treatment is given. [edit]

Clinical features

Bubonic plague becomes evident three to seven days after the infection. Initial symptoms are chills, fever, diarrhea, headaches, and the swelling of the infected lymph nodes, as the bacteria replicate there. If untreated, the rate of mortality for bubonic plague is 30–75%.
In septicemic plague there is bleeding into the skin and other organs, which creates black patches on the skin. There are bite-like bumps on the skin, commonly red and sometimes white in the center. Untreated septicemic plague is universally fatal, but early treatment with antibiotics reduces the mortality rate to 4 to 15%.[1][2][3] People who die from this form of plague often die on the same day symptoms first appear.
With pneumonic plague infecting lungs comes the possibility of person-to-person transmission through respiratory droplets. The incubation period for pneumonic plague is usually between two and four days, but can be as little as a few hours. The initial symptoms, of headache, weakness, and coughing with hemoptysis, are indistinguishable from other respiratory illnesses. Without diagnosis and treatment, the infection can be fatal in one to six days; mortality in untreated cases may be as high as 95%.
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Treatment

An Indian doctor of Russian-Jewish origin Vladimir Havkin was the first who invented and tested an anti-plague vaccine.
The traditional treatments are:

• Streptomycin 30 mg/kg IM twice daily for 7 days
• Chloramphenicol 25–30 mg/kg single dose, followed by 12.5–15 mg/kg four times daily
• Tetracycline 2 g single dose, followed by 500 mg four times daily for 7–10 days (not suitable for children)

More recently,

• Gentamicin 2.5 mg/kg IV or IM twice daily for 7 days
• Doxycycline 100 mg (adults) or 2.2 mg/kg (children) orally twice daily

have also been shown to be effective.[4]