SeminarPlague
Section snippets
Epidemiology
Yersinia pestis was first isolated by Alexandre Yersin in 1894 in Hong Kong,1 after spread of infection from mainland China. The role of fleas in the transmission of plague was subsequently identified.2, 3 Y pestis has been isolated from all continents, and plague is enzootic in various rodents and their fleas in Africa, North and South America, and Asia (Middle East, Far East, and countries of the ex-USSR).4, 5, 6 Between 1987 and 2001, 36 876 cases of plague with 2847 deaths were reported to
Taxonomy and evolution
Multilocus sequence typing of housekeeping genes, a powerful technique for establishment of evolutionary relations between different bacteria, suggests that Y pestis is a clone derived from Yersinia pseudotuberculosis, an enteric pathogen.16 The annotated genome sequences of five strains of Y pestis,17, 18, 19, 20 and one strain of Y pseudotuberculosis21 have been reported, and they show substantial conservation of DNA sequence and gene complement between Y pestis and Y pseudotuberculosis.
Pathogenesis
Many different potential virulence factors have been reported from Y pestis,6, 38 but the phylogenetic data and genome sequence data, coupled with efficient laboratory models of mammalian and insect portions of the Y pestis lifecycle has led to a proposed evolutionary pathway (figure 3). The starting premise for this model is that Y pestis is a specialised clone of the successful enteric pathogen Y pseudotuberculosis which, alone among enterobacteriaceae, has acquired the ability to infect
Clinical features and diagnosis
The onset of bubonic plague is sudden, and is characterised by malaise, dizziness, high fever, and prostration seen at the same time as lymphadenitis. Lymphadenitis in the lymph nodes near the location of a flea bite produces a characteristic tense tender swelling (bubo) after 2–6 days' incubation.5, 28 Generally one painful and erythematous bubo is seen with surrounding periganglionic oedema. The most common location of the bubo is inguinal,8 but it can also be crural, axillary, cervical or
Plague as a weapon
The Japanese army did trials of biological weapons including the use of Y pestis flea bombs on civilians and prisoners in occupied China from 1932 until the end of the Second World War.113 After this war, some countries worked on methods of aerosolising the organism to remove the need for the flea vector11 and to produce primary pulmonary disease. Although the USA's biological weapons programme was unilaterally renounced in 1969,113, 114 the former Soviet Union is alleged to have developed many
Plague control
Y pestis has two main habitats—in the stomach or proventriculus of various flea species at ambient temperature or in the blood or tissues of a rodent host at body temperature.6 An inanimate reservoir in the soil of rodent burrows might exist for some months after their inhabitants have died133 but because of the exacting nutritional requirements or Y pestis,38, 72 it is generally thought to be less well equipped to survive in the environment than other Yersinia species. Soil survival as an
Vaccines
Historically, killed-whole-cell and live-attenuated vaccines have been used, but use has been restricted by local and systemic adverse reactions and short duration of protective immunity. The killed-whole-cell vaccine did not protect against primary pneumonic plague and the live vaccines were ill-defined and retained enough virulence to be unsuitable for current use in human beings.141, 142 These vaccines were recommended only for those working with live Y pestis in laboratories, or those
References (148)
- et al.
Epidemiological and diagnostic aspects of the outbreak of pneumonic plague in Madagascar
Lancet
(2000) - et al.
Studies on the role of plasminogen activator in systemic infection by virulent Yersinia pestis strain C092
Microb Pathog
(1997) - et al.
Chromosomal irp2 gene in Yersinia: distribution, expression, deletion and impact on virulence
Microb Pathog
(1993) - et al.
Turning Yersinia pathogenesis outside in: subversion of macrophage function by intracellular yersiniae
Clin Immunol
(2005) - et al.
Dating the origin of the CCR5-Delta32 AIDS-resistance allele by the coalescence of haplotypes
Am J Hum Genet
(1998) - et al.
Structure and biogenesis of the capsular F1 antigen from Yersinia pestis: preserved folding energy drives fiber formation
Cell
(2003) La peste bubonique à Hong Kong
Ann Inst Pasteur (Paris)
(1894)La propagation de la Peste
Ann Inst Pasteur (Paris)
(1898)Reports of plague investigations in India
J Hyg (Lond)
(1906)- et al.
Plague and other yersinial diseases
Plague and other Yersinia infections
Yersinia pestis—etiologic agent of plague
Clin Microbiology Rev
Human plague in 2000 and 2001
Wkly Epidemiol Rec
Epidemiologic features of four successive annual outbreaks of bubonic plague in Mahajanga, Madagascar
Emerg Infect Dis
Atlas sur la Peste à Madagascar. 2004: 53
Plague as a biological weapon: medical and public health management. Working group on civilian biodefense
JAMA
Primary pneumonic plague in Mukden, 1946, and report of 39 cases with three recoveries
J Infect Dis
Plague manual: epidemiology, distribution, surveillance and control
Biology of plagues: evidence from historical populations
Yersinia pestis, the cause of plague, is a recently emerged clone of Yersinia pseudotuberculosis
Proc Natl Acad Sci USA
Genome sequence of Yersinia pestis, the causative agent of plague
Nature
Genome sequence of Yersinia pestis KIM
J Bacteriol
Complete genome sequence of Yersinia pestis strains Antiqua and Nepal516: evidence of gene reduction in an emerging pathogen
J Bacteriol
Complete genome sequence of Yersinia pestis strain 91001, an isolate avirulent to humans
DNA Res
Insights into the evolution of Yersinia pestis through whole-genome comparison with Yersinia pseudotuberculosis
Proc Natl Acad Sci USA
Application of DNA microarrays to study the evolutionary genomics of Yersinia pestis and Yersinia pseudotuberculosis
Genome Res
Structural organization of virulence-associated plasmids of Yersinia pestis
J Bacteriol
Complete DNA sequence and detailed analysis of the Yersinia pestis KIM5 plasmid encoding murine toxin and capsular antigen
Infect Immun
Age, descent and genetic diversity within Yersinia pestis
The Black Death
Twenty years of plague in India, with special reference to the outbreak of 1917–18
Indian J Med Res
Plague in the orient with special reference to the Manchurian outbreaks
J Hyg (Cambridge)
Varietés de l'espèce Pasteurella pestis. Nouvelle hyphothèse
Bull OMS
Microevolution and history of the plague bacillus, Yersinia pestis
Proc Natl Acad Sci USA
Intraspecific diversity of Yersinia pestis
Clin Microbiol Rev
The Black Death transformed: disease and culture in early Renaissance Europe
Detection of 400-year-old Yersinia pestis DNA in human dental pulp: An approach to the diagnosis of ancient septicemia
Proc Natl Acad Sci U S A
Molecular identification by “suicide PCR” of Yersinia pestis as the agent of medieval black death
Proc Natl Acad Sci USA
Absence of Yersinia pestis-specific DNA in human teeth from five European excavations of putative plague victims
Microbiology
Detection of Yersinia pestis DNA in two early medieval skeletal finds from Aschheim (Upper Bavaria, 6th century AD)
Am J Phys Anthropol
Genotyping, Orientalis-like Yersinia pestis, and plague pandemics
Emerg Infect Dis
Factors promoting acute and chronic diseases caused by yersiniae
Clin Microbiol Rev
Yersiniae—a model genus to study the rapid evolution of bacterial pathogens
Nat Rev Microbiol
Evolution of pathogenic Yersinia, some lights in the dark
Adv Exp Med Biol
Observations on the mechanism of the transmission of plague by fleas
J Hyg (Lond)
Early-phase transmission of Yersinia pestis by unblocked fleas as a mechanism explaining rapidly spreading plague epizootics
Proc Natl Acad Sci USA
Role of Yersinia murine toxin in survival of Yersinia pestis in the midgut of the flea vector
Science
Role of the Yersinia pestis hemin storage (hms) locus in the transmission of plague by fleas
Science
Caenorhabditis elegans: plague bacteria biofilm blocks food intake
Nature
Cited by (266)
The role of the pulmonologist in an armed conflict
2023, Revue des Maladies RespiratoiresYersinia pestis
2023, Molecular Medical Microbiology, Third EditionEndemic Thoracic Infections in Sub-Saharan Africa
2022, Radiologic Clinics of North AmericaInfections due to Salmonella and Yersinia
2022, Medicine (Spain)Histologic Clues to Infection as an Etiology to Lung Disease
2022, Practical Pulmonary Pathology: A Diagnostic Approach