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Various bacteria of the Pasteurella family have been associated with epidemics of plague around the world. About 200 species of rodents may harbor this organism. After an incubation period of 1-12 days a patient develops an acute severe illness. The more common bubonic plague develops abruptly with chills, headache, vomiting, rapid heart rate, prostration, and delirium. A flea bite at the portal of entry rarely can be seen. The “bubo” consists of a matted group of lymph glands, which usually develops pus and drains after 1-2 weeks. Plague may also take the form of pneumonia. Infection may localize in other regions of the body.

Although often misdiagnosed, plague should initially be treated with hot, moist applications. Specific therapy should await a bacteriologic diagnosis. A similar type of illness seen in animal bites with local cellulitis should be treated as most bacterial infections are. If plague is suspected, see a doctor immediately; this illness is extremely infectious.

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Brucellosis or undulant fever is caused by microorganisms transmitted from domestic animals. The acute illness is characterized by fever, while weakness and vague complaints may persist for months to years, when the disease becomes chronic. Three species are found in goats, hogs, and cattle. The infection is usually spread by cow’ s milk or skin contact (udder) with the Brucella organism. When the disease is suspected, appropriate blood tests are needed to confirm the diagnosis. Then specific medical therapy can be instituted. With the appropriate inspection of animals and the avoidance of contaminated milk and milk products, this occupational disease can be well controlled.

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These bacteria, called Hemophilus, cause a variety of diseases. Pharyngitis (sore throat) is commonly seen in children. At times the throat may become severely inflamed, producing inflammation of the valve behind the tongue, the epiglottis (epiglotitis). Shortness of breath, with a reddened, swollen, stiff epiglottis may constitute a medical emergency. Croup also develops in children with a raspy cough, and profound fluid accumulation in the larynx and trachea. If not treated promptly with cool mist and supportive measures it can prove fatal. Pneumonia caused by the Hemophilus organism is usually seen in children, as is also otitis media, a middle ear infection, and meningitis. In these complications prompt bacterial isolation with the appropriate medical treatment will usually prove effective.

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Typhoid fever is a systemic disease caused by Salmonella typhi. The disease is unique to man and characterized by malaise, fever, abdominal discomfort, rash, and enlargement of the spleen. The most prominent complications are intestinal hemorrhage and perforation. In a typical patient not treated with antimicrobials the illness lasts about four weeks. With supportive care, barring complications, the recovery is good, although some “carriers” are known. About 3% of infected patients will continue to excrete organisms in the feces for years. They have been known to infect others where careful screening for food handlers has been lacking.

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A number of germs are normally found in the intestinal tract. These include Escherichia coli, Bacteroides, and many other germs. Some of these are our friends in producing important substances for nutrition, such as Vitamin K and inositol. Invading the body outside the intestinal tract, however, E. coli (the most common intestinal germ, Escherichia coli) is definitely harmful. Infections of the blood stream may occur as a complication of urinary tract infection. These organisms can cause abscesses anywhere in the body tissues.

Children under two years of age sometimes develop an intestinal infection typified by nausea, vomiting, and diarrhea. Many similar outbreaks occurring in nurseries have been associated with a specific strain of E. coli. As with other infections, drainage of pus and the removal of foreign bodies are essential. Often the outcome of these infections depends upon the status of the associated disease, rather than the mere eradication of bacteria.

Next to E.coli, strains of Klebsiella and Enterobacter are the species of intestinal organisms most apt to infect man. Klebsiella is a well recognized pulmonary invader, causing serious bacterial pneumonia. Often the sputum
will contain blood, and cyanosis or shortness of breath may develop rapidly. Chronic infections of the lungs are sometimes seen.

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