Plague is a particularly dangerous infections, once the plague died out whole cities. Neither disease has not had such a tragic impact on the state of the world, like the plague, because of which several times came to a complete standstill culture of Europe. Chronicle of a plague - this is one of the darkest books in the history of our civilization.

The history of pandemics

Plague - a serious infectious disease that manifests severe intoxication, skin, lymph nodes, lungs and other organs. It belongs to the oldest infectious diseases devastating epidemic which causes great damage to the whole of humanity. Plague bacterium causes a small, open at the end of the XIX century.

The first mention of the devastating plague in the territory of modern Libya, Egypt and Syria belongs to the III century BC A little later, the plague appeared in China. A first known pandemic (pandemic - an epidemic that gripped the entire world) occurred in the VI century and entered history as the "Plague of Justinian." Pandemic began in Egypt, spread throughout the Byzantine Empire and took over fifty years, about 100 million. Lives.

The second plague pandemic called the "Black Death." It originated in the fourteenth century in Asia and trade routes penetrated into Europe and then through Pskov has been brought to Russia. During the second pandemic killed about 50 million. People. During the pandemic, the first time in Venice was introduced quarantine as a means to prevent introduction of infection.

In the XV - XVIII centuries, the plague appeared in many countries of the world, including in Russia, but a pandemic, they no longer had.

Third plague pandemic began in 1894 in Hong Kong and trade routes spread to port cities around the world. In Russia, of plague were registered in Odessa at the beginning of the last century. A feature of the third pandemic was that it rarely penetrated inland and is manifested mainly in the bubonic form. At the beginning of the last century, it marked as two plague in Manchuria.

Natural foci of plague

The features of the plague is that the world has its permanent natural foci. These pockets are on the Eurasian, African and American continents. In Russia there are natural foci of plague in the Chita Region, Tuva, in the Altai Mountains in the Republic of Kalmykia in the Volgograd and Astrakhan regions. Many permanent natural foci of plague is on the southern borders of our country in Mongolia and China.

Support the preservation of plague pathogen in natural rodent (more than two hundred species), plague is transmitted from rodent to rodent fleas. That flea determine the geographic location of natural foci, since at low temperature they do not survive. In our country the main carriers of plague are marmots, gray and red marmots, great gerbil, ground squirrel and other small. Secondary carriers (ie not permanent) are house mice, common vole and others.

The forms and methods of infection

The plague can occur in different forms. The form of the disease may be local (skin, bubonic, skin and bubonic), externally-disseminated the spread of infectious agents outside (primary pulmonary, secondary pulmonary, bowel), internally disseminated the spread of infection within the body (primary and secondary-septic septic).

Diseases of the people on the territory of the natural foci of plague are of seasonal nature and depend mainly on the time of the confluence of rodents into hibernation. The natural foci of people get bubonic plague Bubonic plague - the least contagious That only in rare cases is complicated by pulmonary. Bubonic plague in the absence of fleas is almost not transmitted from person to person. Isolation of pathogen into the environment occurs only after opening the bubo.

Home bubonic plague associated with epizootic (disease while a large number of animals) among rodents. At the beginning of the epidemic there is a small number of fleas that can infect humans. The increased incidence of people go along with the growing number of dead rodents and the increasing number of fleas infected with the plague. Extinction of epidemics due to the fact that the reduced number of rodents, and together with them and killed a flea.

Outbreaks of pneumonic plague begin with, the bubonic plague, giving a complication of the lungs and then the person is infectious to others or he develops a primary pulmonary form of plague. This form of plague is spreading rapidly through airborne droplets. From pneumonic plague Pneumonic plague - an instant infection   killed whole families, infected people visiting the sick, and so spreads the infection.

How is the fight against the plague

There are preventive and control measures to combat the plague. Preventive measures are carried out in two main areas: surveillance of natural foci of plague and the prevention of possible importation of plague from other countries.

Control measures are carried out in identifying patients with plague. About the disease is reported immediately by telephone to the higher authorities who organize a special commission to combat the plague. At the same time measures are taken to localize the outbreak. To do this, identify and hospitalize all patients, as well as all persons exposed to them or to their belongings.

Plague - a terrible and not yet fully conquered the infection.

Galina Romanenko

Cirrhotic tuberculosis Tuberculosis - a full recovery is not guaranteed   It meets today quite rare. This is the final stage of tuberculosis, when in place of multiple large foci of infection grows connective tissue, lung shrinks and loses its function. And since the heart is closely associated with the lungs, suffering and the entire cardiovascular system.

Why and how to develop cirrhotic tuberculosis

Cirrhotic pulmonary tuberculosis called a form of the disease in which the lungs and pleura occurs coarse connective tissue proliferation. The process of proliferation of connective tissue predominates over the inflammatory changes in the specific nature of the respiratory organs.

Cirrhotic changes in the lungs develop in the absence of timely resorption inflammatory tuberculosis. This happens when the patient is not treated at all, treatment was administered at the wrong time or were inadequate. In this specific (TB), the process goes to a non-specific inflammatory process with the massive growth of the connective tissue.

Cirrhotic tuberculosis may be unilateral and bilateral. The light may thus appear nekavernoznye cavity (bronchiectasis - bronchiectasis, cysts, etc.) or without a cavity progression. Between the proliferation of connective tissue can meet various size pockets of tuberculosis. In the affected areas of lung atelectasis (lung tissue wears off) can coexist with areas of emphysema (alveoli in these areas, of which the lung tissue, pererastyagivayutsya and lose the ability to sufficient reduction).

Cirrhotic easily reduce in size, sealed and deformed. If the process involved pleura, it thickens and resembles a shell.

Symptoms cirrhotic pulmonary tuberculosis

The disease can occur unnoticed for a long time. Patients appear and gradually increase shortness of breath and weakness, palpitations enhanced even with little physical exertion, there are nagging pain in my heart Pain in the heart - always consult a doctor . Coughing often with sputum, sometimes with blood. Hemoptysis when cirrhotic pulmonary tuberculosis is associated with increased pressure in the pulmonary circulation and rupture of small blood vessels in the bronchi.

Periodically may show signs of tuberculosis intoxication, a tendency to exacerbations of tuberculosis. During the sharpening process can be open, that is beginning to stand out with phlegm Mycobacterium tuberculosis. But after the appointment of adequate treatment process becomes closed.

When unilateral cirrhotic tuberculosis can be seen drooping shoulder on the affected side, the decrease in the volume of the muscles of the shoulder girdle, retraction of tissue above and subclavian areas of narrowing and retracted intercostal spaces. The lower boundary of the affected lung shifted upwards, and healthy lung - down. Government mediastinum shifted toward defeat.

With bilateral cirrhotic tuberculosis chest symmetrical. The upper parts of the chest flattened, marked retraction of tissue above and subclavian areas on both sides, the lower intercostal spaces widened because of which developed emphysema Emphysema - a deadly disease . Acute inflammation of tuberculous process are rare, goes unnoticed and are accompanied by brief secretions Discharges in women when there is cause for concern   sputum Mycobacterium tuberculosis.

The severity of cirrhotic pulmonary tuberculosis depends on how quickly progressing dysfunction of breathing and blood circulation.

The disease can be complicated by significant pulmonary hemorrhage from eroded blood vessels of the bronchial walls or walls of the cavity.

Cirrhotic pulmonary tuberculosis - diagnosis and treatment

Diagnosis is based on examination of the patient's doctor, x-ray evidence of lung (in the X-ray you can see portions of the seal lung tissue of different length in one or both lungs), as well as laboratory data (blood, phlegm), and studies of the functional state of the respiratory and cardiovascular systems.

Treatment of patients with cirrhotic pulmonary tuberculosis carried out in the hospital (during exacerbations), and ambulatory. Patients received physiotherapy (including respiratory), moderate exercise, and selected individual treatment.

At the heart of the complex treatment of such patients should be based on the treatment of tuberculosis. But it should be prescribed drugs that improve the patency of the bronchi (bronchial tubes expand, expectorants and mucus-thinning agents) and the cardiovascular system

Prevention cirrhotic pulmonary tuberculosis is the timely appointment of adequate treatment for patients with all forms of the disease.

Galina Romanenko