The prevention of the plaque is principally determined by the control of the flea population. The flea population must be controlled before the rodents are killed because the fleas will leave the dead rat carcasses and will instead bite humans. A potent antiflea agent that has been used is 2% aldrin.
Chemoprophylactic agents that may be used are tetracycline 500 mg four times daily or sulphonamides 2-4 mg daily for 7 days. For travellers to endemic plague areas there is partially effective formalin-killed vaccine available.
Patients with plaque can themselves be infective, e.g. a patient with pneumonic plague can spread the disease via infected droplets, the suppurated lymph nodes in bubonic plague are infectious.
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