Epidemic plague is best prevented by controlling rat populations in both urban and rural areas. This goal has been reached in the cities, towns, and villages of most developed countries. It has not been achieved in either the rural or urban areas of many developing countries where the threat of epidemic plague continues to exist. Control of plague in such situations requires two things: 1) close surveillance for human plague cases, and for plague in rodents, and 2) the use of an effective insecticide to control rodent fleas when human plague cases and rodent outbreaks occur.
Public Health Education
In regions such as the district Beed where plague is widespread in wild rodents, the greatest threat is to people living, working, or playing in areas where the infection is active. Public health education of citizens and the medical community should include information on the following plague prevention measures:
Eliminating food and shelter for rodents in and around homes, work places, and recreation areas by making buildings rodent–proof, and by removing brush, rock piles, junk, and food sources (such as pet food), from properties.
Surveillance for plague activity in rodent populations by public health workers or by citizens reporting rodents found sick or dead to local health departments.
Use of appropriate and licensed insecticides to kill fleas during wild animal plague outbreaks to reduce the risk to humans.
Treatment of pets (dogs and cats) for flea control once each week.
Preventive Drug Therapy
Antibiotics may be taken in the event of exposure to the bites of wild rodent fleas during an outbreak or to the tissues or fluids of a plague–infected animal. Preventive therapy is also recommended in the event of close exposure to another person or to a pet animal with suspected plague pneumonia. For preventive drug therapy, the preferred antibiotics are the tetracyclines, chloramphenicol, or one of the effective sulfonamides.
The plague vaccine is no longer commercially available in India.