Diagnosis and treatment protocols for Plague in Uganda
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Bubonic Plague (A20.0)
Painful, swollen lymph nodes (buboes). Fever, headache, malaise. Risk: rodent flea bites.
Pneumonic Plague (A20.2) — Notifiable
Very infectious, highly fatal — ISOLATE IMMEDIATELY. Death within 2 days if untreated. Fever, malaise, headache. Frothy blood-stained sputum. May cause respiratory and cardiac distress.
Investigations
Bubo aspirate: microscopy, culture and sensitivity. Blood and sputum: check for Yersinia pestis bacilli.
Treatment
First Line (HC2/HC4)
Doxycycline 100 mg every 12 hours for 14 days. Child >8 years: 2 mg/kg per dose.
Alternative
Chloramphenicol 500 mg orally or IV every 6 hours for 10 days. Child: 25 mg/kg per dose. OR Gentamicin 1.7 mg/kg IV or IM every 8 hours for 7–10 days (adult and child). Note: Use Gentamicin in pregnancy instead of Doxycycline.
Prevention
Health education. Improved housing. Destruction of rats (rodents) and fleas. Early detection and treatment to reduce spread.
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