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You are here: MEDICA Portal. Our Topics in 2009. Topic of the Month February: Forgotten Diseases. Interviews.

"With Protective Masks and Gloves" talked to Peter Schmitz, leading physician at Malteser International, about symptoms of plague, an effective treatment and flea control. Mr. Schmitz, while we know plague only from history books many people still come down with the disease in developing countries. Why is that?

Peter Schmitz: There is a close relationship between disease and poverty. If people are poor, they often live in bad hygienic conditions. In areas where garbage is collected, rats are not far away. These are a potential threat because the disease is spread from rats to humans by the rat flea. I witnessed a plague outbreak in the north of Namibia some years ago. There were about 150 cases. Children had eaten rats before because they had nothing else. That is why they became infected with the plague bacteria.


Photo: African girl How can the disease be diagnosed?

Schmitz: The most common form of plague is the bubonic one. Exterior symptoms like swollen lymph nodes and high fever are characteristic. Pneumonic plague is less spread. A typical symptom is heavy pneumonia. This form leads to death more often. How can people battle plague?

Schmitz: Prevention is effective. It is important to inform the population about the symptoms of the illness. Other effective methods are disease control programmes. If more people become ill as usual, medical staff will carry out mass screenings, for example in schools. The staff should be well skilled which includes a good knowledge of the symptoms of the disease. However, if wars break out, health care will break down and an effective disease control cannot be realised. Malteser International has developed special plague fighting programmes.

Schmitz: Beside medical care we support prevention and information in several aspects. We teach the staff of medical centres diagnosing and treating plague. Moreover, we instruct people to clean their cottages. This is important to keep rats away. We also take action against the rat flea by spraying insecticides. In doing so our staff traverse the cottages with protective masks and gloves. Sweeping the horror of the Middle Ages out of the cottage – does that work?

Schmitz: Absolutely. Activities like that help to reduce the transmission rate and epidemic eruptions can be stemmed. Is it possible to eradicate plague some day?

Schmitz: No, because the plague bacterium remains endemic in many rodents like rats. Furthermore, it is difficult to fight against these animals in areas suffering from bad hygienic conditions. That is why it is very important to inform people about how they can become infected, as well as how to protect themselves. Do you think plague can globally spread again, like tuberculosis for example?

Schmitz: I do not think so, because the number of infections is very small throughout the world. Moreover, the areas where plague occurs are regionally restricted. In contrast to tuberculosis there exist effective drugs. Another difference is that the tuberculosis bacteria are often resistant against antibiotics. They also can be transmitted from human to human. This is the reason why tuberculosis is a greater danger than plague.

The interview was conducted by Simone Heimann.


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