Pneumonic plague is one of three main forms of plague, all of which are caused by the bacterium Yersinia pestis. It is more virulent and rarer than bubonic plague. The difference between the versions of plague is simply the location of the infection. Pneumonic plague is an infection in the lung(s), bubonic plague is an infection of the buboes or lymph nodes, while septicemic plague is an infection in the blood stream.
Typically, pneumonic form is due to a secondary spread from advanced infection of an initial bubonic form. Primary pneumonic plague results from inhalation of fine infective droplets and can be transmitted from human to human without involvement of fleas or animals. Untreated pneumonic plague has a very high fatality rate.
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Pathology and transmission


Pneumonic plague can be caused in two ways: primary, which results from the inhalation of aerosolised plague bacteria, or secondary, when septicemic plague spreads into lung tissue from the bloodstream. Pneumonic plague is not exclusively vector-borne like bubonic plague; instead it can be spread from person to person. There have been cases of pneumonic plague resulting from the dissection or handling of contaminated animal tissue. This is one type of the formerly known Black Plague. It could kill 90%–100% of a population if the victims coughed and passed on the bacteria.


Symptoms

The most apparent symptom of pneumonic plague is coughing, often with hemoptysis (coughing up blood). With pneumonic plague, the first signs of illness are fever, headache, weakness, and rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery sputum.[1] The pneumonia progresses for two to four days and may cause respiratory failure and shock. Without early treatment, patients will die, some within 24 hours.


When they begin, pneumonic plague symptoms can often include:


Fever
Weakness
Headache
Rapidly developing pneumonia with:
Shortness of breath
Chest pain
Cough
Bloody or watery sputum (saliva and discharge from respiratory passages).



Prognosis and treatment

Pneumonic plague is a very aggressive infection requiring early treatment. To reduce the risk of death, antibiotics must be given within 24 hours of first symptoms.[1] Streptomycin, gentamicin, tetracyclines, and chloramphenicol are all effective against pneumonic plague.

Antibiotic treatment for seven days will protect people who have had direct, close contact with infected patients. Wearing a close-fitting surgical mask also protects against infection.[1]

Without treatment, the mortality rate from pneumonic plague approaches 100%.[3]
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Part 2

There is no question that porous particle technology holds tremendous promise for improving drug inhalants, however, by designing a means to circumvent the respiratory system’s natural defenses, this technological advance also presents a classic dual-use dilemma. For example, facilitating deep lung penetration of anthrax spores would increase their lethality by ensuring that more spores make it deep into the lungs.

Inhaled aerosols can likewise transmit the pathogens for pneumonic plague, tularemia, Q fever, smallpox, viral encephalitis, viral hemorrhagic fevers, and botulism, to name a few. The implications are more serious since we know from the anthrax attacks in 2001 that some of the victims who succumbed to inhalation anthrax had been exposed to a much lower dose than past research had indicated necessary to cause disease.

Though much attention by policymakers has been directed at research with select agents and pathogens, other technological advances can clearly lower the barriers to bioweapons development and use. Following the 2001 anthrax attacks, Edwards recognized the existing opportunity to "reverse engineer" an inhaled drug delivery system and increase terrorist ability to bypass natural defenses.

SourceS: Part 1: Wikipedia, Part 2: The Sunshine Project






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