Bubonic plague, a term synonymous with death and devastation, is making headlines again. While a recent case reportedly seen in the UK was found to be a data error, the disease still has the potential to become an global health concern. The germ Yersinia pestis, which causes the plague, continues to thrive in Africa, Asia, and the Americas. Researchers are now racing to create a vaccine as the world becomes increasingly concerned about its possible return.

The most notorious plague epidemic, the Black Death, devastated Europe, Asia, and Africa in the 14th century, killing an estimated 200 million and eradicating almost 60% of Europe's population. This lethal pandemic, which was caused by a combination of bubonic, septicemic, and pneumonic plague, changed the course of history.

A laboratory report by the UK Health Security Agency (UKHSA) of disease cases in England and Wales for the week up to March 13 had first reported a case of bubonic plague. But UKHSA officials later explained that this was a reporting mistake due to a lab misallocation.

The bubonic plague continued to strike in waves over history, with some major outbreaks in the UK, such as the Great Plague of London in 1665 and the last major outbreak in Suffolk in 1918. Although controlled largely with antibiotics nowadays, the disease has never been eradicated.

Yersinia pestis: The Bacterium Behind the Plague

Yersinia pestis is a very virulent bacterium that can spread through a variety of pathways. The most usual method of transmission is by flea bites from rodents to humans carrying the bacteria. Recent studies, however, indicate that human ectoparasites, including lice, are also involved in transmission, especially in historical epidemics when there were few rats.

How does the Plague Spread?

Flea Bites: Infected fleas, which typically reside on rodents, transfer bacteria to humans during bites.

Direct Contact: Transmission is caused by handling infected animals or body fluids of infected animals.

Human Ectoparasites: Recent research has suggested that human lice may serve as carriers, infecting humans upon bite.

Airborne Transmission: During pneumonic plague, bacteria are transferred from individual to individual through respiratory droplets.

Types of Plague and Their Symptoms

Plague is not one disease but occurs in three principal forms:

1. Bubonic Plague

This is the most widespread form of the disease. Symptoms usually develop within 3-7 days of infection and comprise:

• High fever and chills
• Severe headaches
• Muscle pain and fatigue
• Painful swollen lymph nodes (buboes), typically in the groin, armpits, or neck

2. Septicemic Plague

This happens when the bacteria transmit through the bloodstream. Symptoms are:

• Fever and chills
• Abdominal pain and vomiting
• Sepsis developing rapidly, causing necrosis of the tissues

3. Pneumonic Plague

This is the deadliest form of the disease since it transmits through respiratory droplets, and therefore it's extremely contagious. Symptoms are:

• Severe respiratory distress
• Coughing up blood
• Chest pain and shortness of breath
• Rapid development of respiratory failure

Pneumonic plague is treated promptly with antibiotics because it is life-threatening within 24 hours.

Is Plague Still a Threat?

Plague still lingers despite the improvement in medicine. According to the World Health Organization (WHO), between 1,000 to 2,000 plague cases are still being reported every year. Recent occurrences have been in the US, Peru, China, Bolivia, Uganda, Tanzania, and Russia.

Researchers are also concerned that Yersinia pestis can become antibiotic-resistant, which might make treatment harder. Furthermore, the possibility of bioterrorism has focused efforts on more vaccine and second-line treatment studies.

Treatment and Prevention Measures

If plague is detected early enough, it can be very easily treated with the antibiotics:

Streptomycin and Gentamicin: Pitted against Yersinia pestis, these aminoglycoside antibiotics block protein synthesis in bacteria.

Doxycycline and Ciprofloxacin: These are also employed for post-exposure prophylaxis in high-risk exposures.

Early diagnosis and prompt administration of antibiotics can lower mortality rates to below 10%.

Researchers are working hard to create a vaccine for the plague, especially because of the fear of antibiotic-resistant strains. In the past, several vaccines have been created, including:

Live-Attenuated Vaccines: Employed in certain nations, although not popularly accepted because of safety issues.

Formalin-Killed Vaccines: They were given to US troops in Vietnam but proved useless against pneumonic plague.

Newer candidates under investigation are designed to offer greater and more effective protection against all types of plague.

Are We Prepared for Another Plague Outbreak?

With re-emergence possible, health agencies worldwide are following outbreaks closely and spending money on research in hopes of averting another pandemic-sized epidemic. While medicine has better equipment with which to battle the disease today, speedy detection, public awareness, and vaccine development continue to be important to guarantee that the bubonic plague no longer turns into a global catastrophe.

Although the bubonic plague might be perceived as a thing of the past, it is a current and ongoing threat. The recent false alert in the UK is a stark reminder of its latent threat. By learning from its history, mode of transmission, and possible treatments, we can more effectively prevent future outbreaks. While scientists press on with their quest to create a vaccine, public health interventions and ongoing research will be key to containing and eventually eliminating the plague.

Nipah Virus Outbreak India: Two cases of Nipah virus, a rare, bat-borne pathogen had been confirmed in West Bengal. The virus has been detected in two nurses, both working at the private Narayana Multispecialty Hospital in Barasat. Speaking to The Telegraph, Mr Narayan Swaroop Nigam, Principal Secretary, Health and Family Welfare Department, said, "Two nurses at a private hospital are infected with Nipah virus, and one of them is in critical condition."

Was Nipah Virus Found In West Bengal?

A survey conducted on bats in West Bengal found no active Nipah virus infection. Though there were antibodies detected in one specimen, which indicated prior exposure. This was confirmed by a senior state forest department official on Tuesday. The survey was conducted amid the identification of two confirmed Nipah virus cases.

To conduct the survey, nine bats near Kuberpur on the Kolkata-Barasat Road in Madhyamgram were tested using RT-PCR. All samples were negative, however, one bat, tested positive for antibodies. However, it only suggested prior infection, meaning there was no current risk of transmission.

The survey was conducted by the state forest department in collaboration with scientists form Pune-based National Institute of Virology. "The findings are reassuring, but caution is warranted. Surveillance and prevent measures will continue until we are fully assured that there is no risk," confirmed a senior official of the West Bengal Health Department.

What Is Nipah Virus?

As per the World Health Organization (WHO), Nipah virus infection is a zoonotic illness that is transmitted to people from animals, and can also be transmitted through contaminated food or directly from person to person.

In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.

Although Nipah virus has caused only a few known outbreaks in Asia, it infects a wide range of animals and causes severe disease and death in people.

During the first recognized outbreak in Malaysia, which also affected Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via unprotected exposure to secretions from the pigs, or unprotected contact with the tissue of a sick animal.

In subsequent outbreaks in Bangladesh and India, consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.

Human-to-human transmission of Nipah virus has also been reported among family and care givers of infected patients.

Read: Doctor Debunks Five Myths Around Nipah Virus

Nipah Virus Symptoms

• Fever
• Headache
• Breathing difficulties
• Cough and sore throat
• Diarrhea
• Vomiting
• Muscle pain and severe weakness

Unique Symptoms Of Nipah Virus

While most of the symptoms of Nipah virus may resemble the symptoms from any common flu, however, what makes it unique is that the symptoms come in stages.

Dr Shaikh Abdul Kalam, MD Physician, an Andhra Pradesh-based GP writes for Apollo 24 that the symptoms come in three different phases.

Nipah Virus Phase 1: Flu Like Symptoms

Like mentioned above, most symptoms seem like common flu symptoms. Even Nipah virus begins like a common flu or viral infections. This is what makes the diagnosis difficult.

Most common sign is a fever and a headache. It is often a severe headache and does not break with simple pain medication. What follows is myalgia or muscle pain and sore throat.

The initial symptoms could last for 3 to 14 days before more severe symptoms appear. What helps best is to know the patient's travel history to make the right diagnosis.

Also Read: Unique Symptoms Of Nipah Virus Found In West Bengal And How Long Infection Now Last

Nipah Virus Phase 2: Respiratory Symptoms

As the infection progresses, it begins to attack the respiratory system. This causes dry cough, and dyspnea, or acute difficulty with breathing. This means that the virus has started causing inflammation in the respiratory tract.

Atypical pneumonia is also a symptom, which means air sacs in the lungs get filled with fluid and leads to acute respiratory distress.

Nipah Virus Phase 3: Neurological Signs or Encephalitis

This is usually the most dangerous phase of Nipah virus, because it crosses the blood-brain barrier. A person may experience drowsiness, disorientation, and even mental confusion. Complications could lead to seizures and even coma.

All these symptoms could last from 3 to 14 days.

NHS doctors are now warning people against vitamin D tablets as it may have negative health impacts after a prolonged use or due to overdose. Posting on X, an NHS spokesperson said: "From October to March, we cannot make enough vitamin D from sunlight, so to keep bones and muscles healthy, it is best to take a daily 10 microgram supplement of vitamin D. You can get vitamin D from most pharmacies and retailers."

However, this advice comes with a note of caution.

Tobias Mapulanga, biomedical scientist and co-founder of Repose Healthcare, as reported by Wales Online warned people of the overdose of the vitamin D pills. "As the NHS encourages vitamin D in winter, many people are reaching for bottles in the darker months and accidentally overshooting, then blaming the fallout on seasonal bugs; when constant thirst and needing the loo more often, queasiness, tummy pain or constipation, headaches or brain fog, and new aches or cramps appear soon after increasing your intake or adding sprays or gummies, that points to a supplement backfiring. The stakes are clear: the right amount supports you, but doubling up can turn a well-meant routine into feeling worse rather than better,” he explained.

As per a survey, 42% of adults in the UK take vitamin D supplements, and the NHS England shows at least 42 reports over the two years of high-strength vitamin D given more frequently. In some cases, hospitalization for the treatment of hypercalcaemia also were noted.

Four Signs To Keep An Eye For While Using Vitamin D

Vitamin D Overdose: Feeling Frequently Thirsty And Want To Urinate

If you find yourself feeling thirsty or want to urinate more, it could be because you are taking too much of vitamin D. NHS experts suggest to cut the intake to a single 10 microgram tablet and drop any extras if these symptoms appear.

What happens is that excess vitamin D could disrupt fluid and salt balance in the body and thus you may want to visit the loo a little more. Also, keep hydrating yourself. In case the symptoms persist, go to your GP.

Read: Doctors Advise UK Residents To Take This Daily Supplement Until March

Vitamin D Overdose: Burping Constantly, Feel Nausea And Have A Sour Stomach

If you feel like puking, and are burping constantly, for feel like a sour stomach, then try to take your supplement after a meal. If you are taking gummies or spray, it is the best time to switch to a tablet. This happens because food buffers the supplement in the gut and reduces irritation, whereas sprays and gummies contain sweeteners or flavors that could create problems for some people.

Vitamin D Overdose: Bones And Muscles Hurt

If you feel your muscles are cramping more and bones also ache, it is a red flag. The key to this is to prioritize your fluids, mineral -rich foods, and physical activities.

Excess vitamin D could disturb the minerals muscles rely on. Furthermore, dehydration makes cramping worse. You can improve your hydration, drink water with meals and also include yogurt and leafy greens in your food. Include some exercise or gentle stretching in your schedule.

Vitamin D Overdose: Cannot Think Straight

Excess vitamin D could also make your brain fog or cause headaches. So, when you buy any supplement, make sure you read the label. Choose a product listing only cholecalciferol and simple bulking agents. Take it with food at the same time each day to keep intake steady and gentler on the gut. Experts also suggest leaving combined A+D products behind and only pick simple D3 tablet.

When a child is born, parents must decide whether to vaccinate them against a range of preventable illnesses. While immunisations are not mandatory, health authorities strongly recommend them to protect both individual children and the wider community. Some professions, particularly in healthcare, require certain vaccinations as a condition of work.

UK Childhood Vaccination Rates Are Falling

Since 2022, no childhood vaccine in the UK has reached the World Health Organization’s recommended 95 per cent uptake, which is crucial for safeguarding vulnerable populations. As a result, preventable diseases like measles are making a comeback.

What’s Driving The Decline In Vaccination

Several factors contribute to falling vaccination rates. Parents may worry about safety, distrust healthcare systems, or follow religious or philosophical beliefs, such as preferring “natural immunity.” Access issues, like difficulties booking GP appointments, have also played a role, according to a BBC report. A malfunctioning NHS IT system has left thousands of children without appointment letters for essential vaccines.

NHS Doctor Issues Urgent Reminder

As per Mirror, NHS GP Dr Bhasha Mukherjee has shared a crucial message for parents. “Every parent wants to keep their child safe,” she wrote. “But here’s what the data reveals about the real risks today.” Dr Mukherjee highlighted that fewer children receiving full immunisation is directly linked to a surge in vaccine-preventable diseases. “This isn’t theoretical – it’s happening right now,” she added.

Measles Cases On The Rise

In 2024, confirmed measles cases in the UK jumped to nearly 3,000, compared with just 367 in 2023, marking the highest annual figure since 2012. Most cases were children aged one to four and five to ten, with 710 and 730 cases respectively, according to the UK Health Security Agency. Global data also shows over 10 million measles cases in 2023, a 20 per cent increase from 2022, linked directly to drops in routine vaccination coverage.

Whooping Cough and Other Illnesses Are Also Resurfacing

Pertussis, commonly known as whooping cough, is rising too. In England alone, more than 14,000 lab-confirmed cases were recorded in 2024, including hundreds among infants under three months old – the age group most vulnerable to severe illness. Sadly, several deaths were reported. Other diseases, like polio, are also reappearing in regions where children are missing essential jabs.

Why Vaccines Are Still Crucial

Many parents fear side effects, but Dr Mukherjee emphasised the dangers of avoiding vaccination. “Diseases like measles can lead to pneumonia, brain inflammation, hearing loss, long-term disability, or even death,” she said. “Vaccines aren’t perfect, but high coverage protects the whole community, especially infants and children with weakened immune systems.”

MMR (measles, mumps, rubella) vaccination rates in 2023–24 were 88.9 per cent, far short of the 95 per cent needed to prevent outbreaks. Dr Mukherjee warns that this shortfall is driving a resurgence in these serious illnesses.

Choosing not to vaccinate increases your child’s risk of catching real, rising threats – and contributes to outbreaks that put many other children at risk too,” Dr Mukherjee concluded.