Plague

Disease Risk Areas
Areas currently infected include parts of Democratic Republic of the Congo, Ecuador, Madagascar, Malawi Mozambique, Tanzania, Uganda, Zambia, Zimbabwe, Bolivia, Brazil, Ecuador, Peru, Vietnam (WER. 74.4.29/01/1999)

Transmission
Plague is transmitted to humans by fleas from infected rodents (eg.rats) Recommendations for travellers Avoid exposure especially within living quarters and seek prompt advice for feverish illnesses especially if there is lymph node enlargement.
Vaccine is very occassionally advised for those going to to be unavoidably in very close contact with rodents in infected areas.

Vaccination

Always confirm details with manufacturer's literature
Type: Killed.
No of doses: 2(primary course).
Dosages: See literature.
Route: Deep Subcutaneous/C.
Full course: 1-3 months.
1st interval: 1-3 months.
Length of protection: 6 months.
Boosters: Every 6 months.

Side effects
Occasional mild local reactions have been reported.

Contraindications:
Any acute, febrile illness.

Plague vaccine is no longer available in Britain and is rarely indicated.

Extra Notes
24/11/98 Global figures for 1996 The total number of plague cases in 1996 reported by 10 countries was 3017 with 205 fatalities.
These figures represented a slight increase from 1995( 2861 cases notified) and considerably exceeded the previous 10 years when the average number was 1719 per year. The global case fatality rate was 7% as compared to 4.8% in 1995 and 9.3% per year in the previous decade.
19/11/97 The total number of human plague cases reported to WHO in 1995 by 10 countries was 2,861. Of these 137 were fatal. A slight decrease of human plague cses was noted, particularly in Asia, while narly 90% of the cases were reported from Africa.
09/03/94 We have removed plague as a sometimes recommended vaccine since it is so rarely indicated, but have retained it in the tables of 'other disease risks'.
08/12/93 Totals of plague cases reported to WHO in 1992 were: World total: 1758 with 198 deaths. Africa: 558 with 166 deaths (Madagascar:198 and Zaire:214). Americas: 158 cases with 6 deaths (Peru:120; Brazil:25, USA:13). Asia: 1012 cases with 26 deaths(China:35; Mongolia:12 Myanmar:528 and Vietnam:437)