Microcheck 283

Generally, tularemia is a bacteremic disease of wild animals transmitted to humans by exposure to their blood or tissues, or by biting insects. Brucellosis is most commonly a disease of domestic animals transmitted to humans by handling their flesh or by drinking unpasteurized milk. Plague is endemic in rodents in the western United States and is transmitted to humans by flea bites. Unlike tularemia and brucellosis, plague has the potential to spread rapidly from human to human by coughing, with a high fatality rate.

■ Workers in what industry are especially likely to contract brucellosis? How can they protect themselves from the disease?

■ How would growth within phagocytes protect Francisella tularensis from destruction by antibodies?

■ How would crowded conditions in cities favor spread of plague?

Nester-Anderson-Roberts: I IV. Infectious Diseases I 28. Blood and Lymphatic I I © The McGraw-Hill

Microbiology, A Human Infections Companies, 2003

Perspective, Fourth Edition

726 Chapter 28 Blood and Lymphatic Infections

Table 28.5 "Black Death" (Plague)

Causative organism Yersinia pestis is contracted from the bite of an infected flea or scratching skin contaminated by the flea's feces

The bacteria are carried by the lymphatics to regional lymph nodes CD

Phagocytes ingest the bacteria but the intracellular conditions activate capsule production and other genes responsible for virulence

Fully virulent bacteria break out of the phagocytes, infect the nodes, producing buboes, bubonic plague

The bacteria may be carried into the bloodstream, causing septicemic plague

The lungs can become infected, producing the highly contagious and lethal pneumonic plague

@ Bacteria exit with coughing

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