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PLAGUE
PLAGUE
Bubonic and Pneumonic
Prophylaxis: CHILDREN:
Oral medication only-Human or Animal Grade
Do NOT give Children "Shots "!
When Children are considered Children:
Doxycycline-100 pounds and under
Tetracycline 8 years and under
Oxytetracycline-8 years and under
Penicillin- 60 pounds and under
Cipro- Do not give to humans under 19 years
Clark's Rule: Weight *best*
Divide the child's weight by 150 lbs. then multiply that number by the ADULT
daily dose total. The answer equals the child's total daily dose. For
instance, a dosage for a 60 pound child is computed thusly: 60/150 = 0.4
Now multiply that by the minimum daily dose for an adult and you get:
0.4 X 200mg (Doxycycline) 80mg
or 80mg for a daily dose total of Doxycycline. However. Doxycycline only
comes in 50mg and 100mg tabs so, the dosage for the 50 pound child can be
adjusted to:
5omg every 12 hours (q12h) x 30 days or duration of exposure-whichever is
longer.
Total daily dose = 100mg.
Example: 50 pound child taking Tetracycline and Oxytetracycline would compute
(50/150 times 3000mg) or a 1000mg daily dose total.
This dosage would be:
250mg every six hours (q6h) X 30 days or Duration of exposure--whichever
comes first
Young's Rule:
AGE
Divide the age of the child by his age + 12. For instance the calculations
for a 3 year old child would be 3 divided by 3+12 (15) or 3/15.
Thus 1/5th of the daily adult dose total.
Cowling's Rule:
AGE
Divide the number of the NEXT birthday by 24. For example: a 5 year old
child's dose would compute: 6 divided by 24 equals 6/24 or 1/4 of the daily
adult dose/dosage total.
PLAGUE
Control
Isolation:
When handling infected humans wear Kitchen Gloves, Poncho, Mask, and Eye
Protection
Strict isolation of patients with Pneumonic Plague Sanitary procedures for
Bubonic Plague
Decontamination:
Wash or Spray all contaminated objects with:
0.5% Bleach or Iodine solution or Germicidals. Food CANNOT be decontaminated
To decontaminate drinking water using:
USP Iodine Crystals -Saturated Solution
Add 8 grams of Iodine crystals to a 2 ounce clear glass bottle with a
bake-lite cap. NO Plastic!
Fill with water and shake vigorously for several minutes, then let settle.
Without disturbing the
sediment, withdraw 6 teaspoons (30cc) of the saturated solution and add to a
quart of tepid water. Let stand
for at least 60 min. To make more of the saturated solution "batch", just
add more water to the sediment
in the two-ounce bottle and -shake.
Remember: When there is no more sediment-start another "batch".
Contamination Prevention:
Eat only sealed foods.
Drink only sealed water.
Avoid air conditioning.
Avoid crowds.
Wear a face mask
Wear kitchen gloves.
Wear a poncho.
Wear boots.
Disposal: Human or Animal
Burn the carcasses OR bury them with quick lime. Clothing and bedding should
be burned.
Preventing Outbreaks
Since Pneumonic Plague is quite contagious from human to human, strict
isolation must be employed! Bubonic Plague is contracted from the infected
flea/rodent population, therefore, pest control must be implemented.
Pesticides for the insects. Poison for the rodent population. Burn the
carcasses.' Do not -use dogs or cats to control rodents.
PLAGUE
Bubonic And Pneumonic Plague
Description
Plague is a gram-negative bacteria (Yersinia Pestis) and may be spread from
human to human in sputum droplets (or intentional aerosol) once the disease
has gone Pneumonic or by the bite of infected fleas. As a weapon. consider
Plague quite Deadly!
Signs and Symptoms:
Pneumonic-(lungs)-incubation 2-3 days. High fever, chills, headache, bloody
discharge from the mouth and nose, progressing to laboured and harsh
breathing, and bluish skin. Death follows onset of severe symptoms (usually
48 hours) from respiratory failure and circulatory collapse. Untreated,
Pneumonic Plague has a 90% mortality rate. Antibiotic Prophylaxis would be
successful.
Bubonic-Black Death-Incubation 2-10 days. Rapid pulse, rise in temperature,
enlarged lymph nodes (buboes) with surrounding swelling. The node may turn
black from dead tissue. Within two weeks the buboes generate pus. Untreated,
Bubonic Plague has a 60% mortality (usually in 3-5 days). Antibiotic
Prophylaxis would be successful.
Septicemic-Blood infection
Septicemia may occur at any time during the course of either Bubonic or
Pneumonic Plague. Death is swift once the disease is bloodbourne Antibiotic
Prophylaxis would be successful.
War Engine:
Bubonic Plague can be spread by infecting a rodent population (such as in a
sewer system). Fleas would then spread the disease to humans. Cats have been
known to spread Pneumonic Plague to humans.
Pneumonic Plague can be delivered by aerosol (spray). Thus delivered,
Pneumonic Plague is a certainty as well as Bubonic. Food and water will
become contaminated.
PLAGUE
Pneumonic and Bubonic
Prophylaxis: Adults
Oral medications only
DOXYCYCLINE: Adults 100 pounds or over Doxycycline (Vibramycin) pills or
capsules.
1) Minimum adult dosage for Doxycycline = 100mg every 12 hours (BID/q12h) x
30 days or
Duration of exposure--whichever is longer This is a total of 200mg per day.
2) Maximum adult dosage for Doxycycline = 100mg every 8 hours (TED/q8h) x 30
days or
Duration of exposure-whichever Is longer. This is a total of 300mg per day
TETRACYCLINES: Adults 8 years and over Adult DOSAGES: Tetracycline or
Oxytetracycline.
1) Minimum adult dosage for the Tetracyclines = 500mg every six hours (q6h)
x 30 days or
Duration of exposure-whichever is longer. This is a daily total of 2,000mg
2) Maximum adult dosage for the Tetracyclines = 500mg every four hours (q4h)
x 30 days or
Duration of exposure-whichever is longer.This is a daily total of 3,000mg
Ciprofloxacin--not for Humans under 19 years Unknown but suspected "useful"
as a prophylaxis Adult DOSAGES: Cipro Ciprofloxacin.
1) Minimum adult dosage for Cipro = 250mg every 8 hours (T1D--q8h) X 30 days
or
Duration of exposure-whichever is longer. This is a daily total of 750mg
2)Maximum adult dosage for Cipro = 500mg every 12 hours (BID) X 30 days or
Duration of exposure-whichever is longer This is a daffy total of 1000mg.
Penicillin-Not as effective as the Tetracyclines. However, if allergic to
the Tetracyclines TAKE:
Dosage for Pen V-K
500mg every 6 hours X 30 days or
Duration of exposure-whichever is longer
This will be a daily total of 2000mg
PLAGUE
Treatment
For patients not taking Prophylaxis
Pneumonic &Ad Bubonic Plague:
Adults and Children:
Streptomycin - IM- (intramuscular) q12h (BID) Treatment should begin within
24 hours of onset of symptoms of Pneumonic Plague-- The treatment of choice
is Streptomycin I.M. The formula is simple, (30mg per kg of body weight per
day for 10 days) Divide into two equal shots.
1 kilogram (kg)equals 2.2 pounds so a 110 pound human would weigh about 50
kg. Therefore; 30mg x50 = 150mg daily for 10 days.
750mg IM (Buttocks) every 12 hours for 10 days.
Adults Only IV. Drip
Doxycycline--IV. Drip-Ringers or D5&W
The formula is as follows:
First give 200mg IV. Drip (loading) then 100mg IV. Drip every 12 hours for
14 days
Children Only IV. Drip
Doxycycline - IV Drip - Ringers or D5&W
For Children under 100 pounds as follows:
4-4mg per kg of weight, IV Drip (loading) then 2.2mg per kg of weight IV.
Drip every 12 hours.
Adults Only-Oral:
Doxycycline Oral--pills or capsules
200mg (loading) then 100mg every 12 hours for 14 days
Children Only-Doxycycline Oral
See: Clark's Rule
Dose every 12 hours for 14 days (Oral)
Adults Only-Oral
Tetracycline and Oxytetracycline 500mg every four hours for 14 days (Oral)
Children Only-Tetracycline/Oxytetracycline
See: Clark's Rule
Dose every four hours for 14 days (Oral)
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