(b) A patient suffering from pneumonic plague has a severe headache
and an explosive onset of high fever (103-106F). The disease involves the patient's
pulmonary processes to include a bloody, frothy productive cough, dyspnea, tachypnea,
plural pain or dull substernal oppression, rales, and impaired percussion. The other
signs are chills and tachycardia. In the later stages of the disease, the patient has
severe dyspnea, cyanosis, and heart failure.
(c) Septicemic plague is another form of plague. It usually comes on
suddenly and with great severity to a patient suffering from bubonic plague. This form
of plague may be fatal although the patient is also ill with bubonic plague.
(3) Treatment. If plague is suspected, begin therapy immediately. The
treatment of choice is streptomycin, 30 mg/kg per day administered intramuscularly in 4
equal doses given every 6 hours. After this, give 0.5 g intramuscularly at 6-8 hour
intervals. At the same time, administer tetracycline (2 g) orally, but if necessary, give it
parenterally. If required, use IVs, pressor drugs, oxygen or a tracheostomy. Strict
isolation techniques should be adhered to in cases of plague.
(4) Prevention and control. Extensive rodent and flea control measures are
necessary, but it is rarely possible to achieve total eradication from rodents in endemic
situations. For those individuals who are exposed to the risk of plague infection,
temporary protection may be provided through the administration of tetracycline
hydrochloride (500 mg orally 2-4 times daily for 5 days). Vaccines have been used for
years; however, their effectiveness has not been clearly established.
Section V. MOSQUITO-BORNE DISEASES
Most disease-carrying mosquitoes are found in milder climates and in the tropics.
The female mosquitoes are the vectors of disease (transmit the causative organism of
disease to a susceptive person). The more important diseases which are transmitted by
mosquitoes include malaria, yellow fever, dengue fever, viral encephalitis, and filariasis.
Malaria is the greatest threat to military operations, so lesson 4 will list details of this
1-11. DISEASES TRANSMITTED BY MOSQUITOES
a. Yellow Fever.
(1) General. Yellow fever is an acute viral infectious disease transmitted by
the Aedes and jungle mosquitoes. It is found in Africa and South America; however,
some epidemics are found far into the temperate zone when the season is warm. The
transmission occurs when a mosquito bites an infected person and then later bites a
susceptible person (the virus multiplied in the mosquito's body).