Treatment and Diagnosis of Plague

Inclusion Criteria: * 2 years of age or older. * Patients must have had potential exposure to rodents and/or their fleas or contact with a known plague case. * Patients must have a fever of at least 38 °C that developed rapidly, and have one of the following: * One or more buboes (defined as tender lymph node swelling \>=1 cm) that appeared after or at the same time as the fever; or * Clinical suspicion of pneumonic plague (prostration, cough, increased respiratory rate, hemoptysis and/or purulent sputum); or * Clinical suspicion of plague AND an epidemiological link with other cases. * Only patients that are later confirmed by standard diagnostic tests will be included in the final analysis. Patients who do not have plague confirmed by standard tests will still be included in the safety analysis. Exclusion Criteria: * Has signs fitting plague meningitis (severely ill patient with signs of plague and one or more of the following: headache, fever, sensorial disturbances, neck and back stiffness, and/or positive Kernig and Brudzinski signs). * Has hypotension unresponsive to fluid therapy (i.e. shock). In adults hypotension is defined as systolic blood pressure \< 80 mmHg and heart rate \> 110/min; in children it will need to be diagnosed by attending physician or medical officer. * Has an "illness severity score" of 16 or higher (see Patient Record) * Has a known allergy to gentamicin, streptomycin, or trimethoprim-sulfamethoxazole * Is receiving dialysis for renal f…