Bubonic plague primary prevention

Prevention
Plague will probably continue to exist in its many localized geographic areas around the world, and plague outbreaks in wild rodent hosts will continue to occur. Attempts to eliminate wild rodent plague are costly and futile. Therefore, primary preventive measures are directed toward reducing the threat of infection in humans in high risk areas through three techniques -- environmental management, public health education, and preventive drug therapy.

Environmental management
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 American West 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.