- People who live, work, or play in areas with active plague infection in wild rodents should take these precautions:
- Eliminate food and shelter for rodents around homes, work places, and certain recreation areas, such as picnic sites or campgrounds where people congregate. Remove brush, rock piles, junk, and food sources, including pet food.
- Allow health authorities to use appropriate and licensed insecticides to kill fleas during plague outbreaks in wild animals.
- Treat pets (cats and dogs) for flea control regularly.
- Avoid sick or dead animals, and report such animals to the health department. Hunters and trappers should wear rubber gloves when skinning animals.
- Use insect repellents when outdoors in areas where there is a risk of flea exposure.
- Preventive treatment with antibiotics is recommended for: 1) people who are bitten by fleas during a local outbreak or who are exposed to tissues or fluids from a plague–infected animal; 2) people living in a household with a bubonic plague patient, since they may also be exposed to infected fleas; and 3) people in close contact with a person or pet with suspected plague pneumonia. Close contacts defined as face–to–face contact or being in the same closed space, such as a room or vehicle.
- People who travel to countries where plague occurs should take these additional precautions:
- Avoid exposure to fleas from diseased rats. The risk of being bitten by infected fleas is especially high after large numbers of plague–infected rats have died. Therefore, avoid places that are infested with rats or where large numbers of rats have reportedly died.
- If travel to such areas is essential, apply insect repellent containing DEET to legs and ankles. Also apply repellents and insecticides to clothes and outer bedding according to manufacturers’ instructions.
- Take preventive antibiotics if the risk of exposure is high.
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.