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9 : Plague as an Emerging Disease

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Abstract:

This chapter reviews the changing epidemiology of plague over the past several decades and discusses factors of plague emergence or re-emergence. Three biotypes of , classified according to their ability to ferment glycerol and reduce nitrate, are correlated with the three major plague pandemics of history. Effective strategies to prevent and control the spread of plague were made possible by an understanding of its ecology and epidemiology. Epidemiologic investigations revealed that, with rare exception, human-to-human plague transmission occurs only as a result of close contact of persons with a case of pneumonic plague and that contagious spread could be interrupted by isolating plague patients. Many of the natural foci of plague are being increasingly invaded by humans and are undergoing dramatic man-made environmental changes. Under some circumstances, a changing rural environment such as suburbanization in the southwestern United States may increase human risk. An important factor today in the epidemiology of plague is its entrenchment in natural rural cycles. The ability to detect, monitor, and respond to plague is based on a solid public health infrastructure. In addition to routine laboratory studies, there is an important role for advanced genetic techniques to define the molecular epidemiology of plague and to detect and characterize newly evolving traits, such as virulence factors and factors associated with antimicrobial resistance.

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9

Key Concept Ranking

Infectious Diseases
0.6233226
Pneumonic Plague
0.5403902
Bubonic Plague
0.4777261
Antimicrobial Susceptibility Testing
0.4454591
Antimicrobial Resistance
0.4002436
0.6233226
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Figures

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Figure 1

Distribution of natural foci of plague. Symbols: countries reporting plague between 1970 and 1997; ▪. probable sylvatic foci. (Compiled from data provided by the WHO, CDC, and other sources.)

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Figure 2

Animal and human plague transmission, demonstrating the interrelationship of the wild rodent and domestic rodent cycles and the routes of incidental infection of humans. (Adapted from reference .)

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Figure 3

Map of the world showing sites of human plague outbreaks in the period from 1991 to 1995.

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Image of Figure 4
Figure 4

Plague cases reported to the World Health Organization, by geographic region, 1948 10 1994, showing marked decrease in cases in Asia and a recent increase in cases in Africa (note difference in scale for cases).

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Image of Figure 5
Figure 5

Plague cases worldwide reported to the WHO from 1980 to 1995, showing a nearly sixfold increase.

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Image of Figure 6
Figure 6

Human plague cases, United Slates, 1900 to 1994, by 5-year intervals, showing peak activity during urban plague outbreaks in the early 20th century, a period of quiescence, and recent resurgence due to increased rural plague in south-western states.

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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Figure 7

Number of human plague cases reported by state and decade in the United States from 1944 to 1993 (total, 362 cases), showing increasing numbers of cases, increasing number of states reporting cases, and an eastward shift in state of occurrence.

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9
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References

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Tables

Generic image for table
Table 1

Reported cases of plague in humans. by country. from 1981 to 1995

Citation: Dennis D. 1998. Plague as an Emerging Disease, p 169-183. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch9

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