- Madagascar. In the event of lymph node enlargement in the groin, plague should be considered as the most likely diagnosis. Do you agree?
- Botswana. When confronted with a case of plague, the first thing to do is try to eradicate all rats. Do you agree?
- In bubonic plague, bacilli will almost always be found in the peripheral blood. Correct?
- Zimbabwe. A pregnant woman is admitted with sudden very high fever and considerable pain in the groin. A large bubo is present with foul-smelling liquid. This has occurred very recently. What do you do?
- "It reeks like the plague". Where does this expression come from?
- Nepal. A thin 40-year-old man presents with chronic back pain, moderate fever and general malaise. You notice a fluctuating mass (abscess) in the right groin which does not feel hot. Any ideas?
- India. Following an unexpected outbreak of plague, not enough streptomycin is available in the short term. Do you want penicilline, chloramphenicol or tetracyclines to be dispatched urgently? Why does your colleague in the crisis team order malathion?
- New York, USA. What is the expected impact of a terrorist attack with aerogenic plague? Which strategic stocks should be called up?
- Oman. A German engineer notices an insect bite on his left leg. He is able to catch the insect and it is positively identified as Xenopsylla cheopis. A few days later he feels generally unwell, dizzy, tired and he has a headache. Five days later he notices enlarged cervical and axillary lymph nodes. He is febrile, his throat is irritated and there are some red spots on his palate. He has a skin rash on his face and trunk. A RPR is performed, but this is negative. He seeks your advice. What else do you ask and why?
- Discuss a possible epidemiological role for cats in the transmission of urban plague.
