Plague is a severe and potentially deadly bacterial infection which affects rodents, certain animals and humans. Caused by the bacterium Yersinia pestis, the disease cycles among wild rodents such as rats and spreads via their fleas. People are at risk if they are bitten by a flea carrying the bacteria from an infected rodent, if they are scratched or bitten by infected domestic cats or if they handle or skin infected animals such as prairie dogs, squirrels, rats and rabbits.
In the Middle Ages, massive plague epidemics spread through Europe. The “Black Death” killed 50 million people during the 14th century. Plague still occurs in Africa, Asia and South America. It is rare in the United States but has occurred in rural and semi-rural parts of Arizona, California, Colorado and New Mexico.
Plague occurs any time of year; most U.S. cases happen in late spring to early fall. Plague first arrived in the United States in 1900 via rat-infested steamships sailing from affected areas, mostly Asia, causing epidemics in port cities. Today, about seven human plague cases are reported here each year. People of all ages are susceptible, but 50 percent of cases occur in those between the ages of 12 and 45. Worldwide, between 1,000 and 3,000 plague cases each year are reported to the World Health Organization, although the actual number is likely higher.
The use of antibiotics has greatly reduced mortality, which is now about 11 percent; however, plague can still be fatal. It is difficult to assess the mortality rate in developing countries as few cases are reliably diagnosed and reported.
Pneumonic plague, an infection of the lungs, spreads from person to person. When a person or animal, especially a cat, with pneumonic plague coughs, tiny droplets carry the bacteria through the air. Anyone who breathes in these particles may catch the disease; this can start an epidemic.
Symptoms appear suddenly two to three days after exposure and include severe cough, fever, frothy and bloody sputum, pain in the chest or difficulty breathing.
More than 80 percent of U.S. plague cases are bubonic, an infection of the lymph nodes which is not transmitted person to person. Symptoms appear suddenly within two to five days and include chills, fever, a general sick feeling, headache, muscle pain and seizures. A painful swelling of lymph glands called a bubo may appear, commonly in the groin but also in the armpits or neck, frequently at the site of a bite or scratch. Pain may occur before swelling appears.
Septicemic plague, a plague infection of the blood, may cause death before symptoms occur. Symptoms include abdominal pain, bleeding due to clotting problems, diarrhea, fever, nausea and vomiting.
Call your health care provider if you develop symptoms after exposure to fleas or rodents, especially if you live in or visited an area where plague occurs. Tests include culture of the blood, lymph node aspirate (fluid from lymph nodes) and sputum. Preliminary results are available in less than two hours; confirmation takes 24 to 48 hours.
Seek immediate treatment if plague is suspected; death can result if treatment is not received within 24 hours of the first symptoms. About 50 percent of persons with bubonic plague and almost everyone with pneumonic plague dies if not treated. Antibiotics to treat plague include streptomycin, gentamicin, doxycycline and ciprofloxacin. Patients may require oxygen, intravenous fluids, respiratory assistance and supportive care in a hospital critical care unit.
Patients with pneumonic plague should be strictly isolated from caregivers and other patients. All health care staff must wear gowns, gloves and masks and observe strict isolation techniques to avoid accidental contamination and spread of the disease. Anyone in contact with a person with pneumonic plague should be watched carefully and given antibiotics.
Immediately notify local and state health departments so they can investigate and control the problem. There is concern about pneumonic plague being used as a bioweapon since it can spread through an aerosol attack. If bioterrorism is suspected, the health departments will notify the Centers for Disease Control and Prevention, the FBI and other authorities. National and state public health officials stock large supplies of medications which can be sent anywhere in the United States in 12 hours. The U.S. Department of Defense, the CDC, the U.S. Department of Energy and the National Institute of Allergy and Infectious Diseases are working together to develop a vaccine to protect against inhalationally acquired pneumonic plague, as well as antibiotics and interventions to treat and prevent infection.
Although sunlight and drying destroy plague bacteria, it can survive for an hour when released into the air. Currently, no plague vaccine is available in the United States. Rat control and watching for the disease in the wild rodent population are the main control measures.
Concern for travelers is generally low except in rural areas or regions at risk, particularly if camping or hunting or if there is contact with rodents. The three most endemic countries are Madagascar, the Democratic Republic of Congo and Peru. Madagascar experienced an outbreak in November 2014, with 119 confirmed cases, including 40 deaths. The WHO publishes a global alert in response to plague outbreaks.
The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.
The Global Business Travel Association’s (GBTA) Convention 2021 will be unlike any other convention before it, as we come together in person for the first time since the business travel industry drastically changed and look forward to rebuilding and reshaping the future. GBTA Convention 2021 will bring all of us together to learn from experts and each other, in-person at Orange County Convention Center in Orlando, Florida, Nov. 17–19. The safety of our attendees is our top priority. View health and safety protocols.
I imagine that when writer Hans Christian Andersen mused, “Life itself is the most wonderful fairy tale,” he was standing at the edge of Copenhagen’s historic Tivoli Gardens, one of his favorite haunts, enlivened by the swirl of human happiness that surrounded him: children laughing; carousels spinning; games of chance played for prizes; lovers holding hands; hungry people whispering over sweets, hot drinks, beer and towering, open-faced smørrebrød, Denmark’s quintessential sandwich. That fairy tale lives on today at the second-oldest amusement park in the world, a spectacle of folly architecture, bakeries, gardens, rides, restaurants, puppet shows and joy ... and which also happens to be one of the city’s most storied places to convene for business.
The restored Park Hyatt Toronto reopened its doors, bringing luxury, sophistication and glamour alongside a nod to the hotel’s Canadian heritage. Alessandro Munge of Studio Munge collaborated on the hotel’s refresh, drawing inspiration from Canada’s seasons and natural landscapes.
Without a doubt, the pandemic changed the role of airports in the travel industry. Hamad International Airport’s role evolved in many ways since the pandemic hit. Now, more than ever, airports are responsible for creating a secure passenger experience. As the gateway to Qatar and the world, the safety and wellbeing of staff and passengers has always been at the core of Hamad International Airport’s strategy.
I recently dined at Irwin’s in Philadelphia. The restaurant is located on the rooftop of the Bok Building, a former school turned collective of small businesses, non-profits, artist workshops, a bar and restaurant. I previously visited Bok for the bar and yoga classes, and I was excited to experience the restaurant.
Cathay Pacific reaffirms its commitment to reaching net-zero carbon emissions by 2050 with a pledge to use Sustainable Aviation Fuel for 10 percent of its total fuel consumption by 2030. The airline has made pioneering efforts in supporting SAF development for more than 10 years.
GBTA’s Convention 2021 will bring the business travel industry together for the first time in a long time. Once again, you’ll learn and connect with experts and each other, along with discussions with leading thinkers, entrepreneurs and change makers addressing the issues that matter most.
Arriving early afternoon in Puerto Rico, we jumped in an Uber and took a short, 15-minute drive from the airport to La Concha. As it was Tuesday, the streets were not too busy and the hotel lobby was calm. During the weekend, the scene likely would have been more bustling. We were greeted by a staff member who requested proof of vaccination and government-issued ID, and were given a wristband to indicate we were fully vaccinated. All guests are required to be vaccinated and wear masks at all times while moving around the hotel. Hand sanitizer stations were placed around the lobby, in elevators and in each common area.