Death, if it occurs, is typically within 10 days. With treatment, the risk of death is around 10%. Globally between 2010 and 2015 there were 3,248 documented cases, which resulted in 584 deaths. The countries with the greatest number of cases are the Democratic Republic of the Congo, Madagascar, and Peru.The plague is considered the likely cause of the Black Death that swept through Asia, Europe, and Africa in the 14th century and killed an estimated 50 million people, including about 25% to 60% of the European population. Because the plague killed so many of the working population, wages rose due to the demand for labor. Some historians see this as a turning point in European economic development. The disease is also considered to have been responsible for the Plague of Justinian, originating in the Eastern Roman Empire in the 6th century CE, as well as the third epidemic, affecting China, Mongolia, and India, originating in the Yunnan Province in 1855. The term bubonic is derived from the Greek word βουβών, meaning "groin". Cause
Bubonic plague is an infection of the lymphatic system, usually resulting from the bite of an infected flea, Xenopsylla cheopis (the Oriental rat flea). Several flea species carried the bubonic plague, such as Pulex irritans (the human flea), Xenopsylla cheopis, and Ceratophyllus fasciatus. Xenopsylla cheopis was the most effective flea species for transmittal. In very rare circumstances, as in septicemic plague, the disease can be transmitted by direct contact with infected tissue or exposure to the cough of another human.
Propantheline bromide (INN) is an antimuscarinic agent used for the treatment of excessive sweating (hyperhidrosis), cramps or spasms of the stomach, intestines (gut) or bladder, and involuntary urination (enuresis). It can also be used to control the symptoms of irritable bowel syndrome and similar conditions. This agent can also be used for patients who experience intense GI symptoms while tapering off of TCAs. Indications
By relaxing the gut muscle, propantheline can relieve pain in conditions caused by spasm of the muscle in the gut. Relaxing the smooth muscle in the bladder prevents the involuntary spasms that can allow leakage of urine from the bladder in the condition known as enuresis (involuntary urination in adults). Propantheline can also be used to treat excessive sweating because acetylcholine block also reduces secretions such as sweat and tears. Adverse effects
Side effects include tachycardia, constipation, hypersensitivity to light, dry mouth, and urinary retention. This can also be prescribed by dentists for certain patients who salivate excessively. By giving this medication it becomes easier to do "dry" dentistry. Mechanism of action
Propantheline is one of a group of antispasmodic medications which work by blocking the action of the chemical messenger acetylcholine, which is produced by nerve cells, to muscarinic receptors present in various smooth muscular tissues, in places such as the gut, bladder and eye. Normally, the binding of acetylcholine induces involuntary smooth muscular contractions. == References ==