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[The plague: An overview and hot topics].
A Galy1, P Loubet1, N Peiffer-Smadja1
1Service de maladie infectieuses et tropicales, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; IAME, UMR 1137, Inserm, université Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France.
Plague, a bacterial zoonosis caused by Yersinia pestis, presents in bubonic, pulmonary, and septicemic forms. Early diagnosis and treatment are crucial for survival, with public health measures and poverty reduction key to controlling this re-emerging disease.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Plague is a bacterial zoonotic disease caused by Yersinia pestis, primarily affecting rodents and transmitted by fleas.
- It manifests in three clinical forms: bubonic, pulmonary, and septicemic, with varying and often high fatality rates.
- Yersinia pestis is a Gram-negative bacterium, posing a significant public health threat, especially in endemic regions.
Purpose of the Study:
- To provide a comprehensive overview of plague, including its causative agent, transmission, clinical manifestations, and diagnosis.
- To discuss current treatment recommendations and highlight the re-emerging nature of the disease.
- To emphasize the importance of public health interventions and socioeconomic factors in plague control.
Main Methods:
- Review of existing literature on Yersinia pestis and plague.
- Analysis of clinical presentations and diagnostic techniques.
- Examination of epidemiological data and public health strategies.
Main Results:
- Plague is transmitted via flea bites, rodent contact, or inhalation, with an incubation period of 1-7 days.
- Bubonic plague has a 50% fatality rate without treatment; other forms are nearly always fatal.
- Diagnosis involves bacteriological, serological, rapid diagnostic tests, and PCR; treatment has evolved with fluoroquinolones and cyclins recommended.
Conclusions:
- Plague remains a significant re-emerging infectious disease, as evidenced by the 2017 epidemic in Madagascar.
- Effective control requires integrated public health measures, poverty alleviation, and improved vaccines for endemic areas.
- Peru and the Democratic Republic of Congo are identified as endemic regions requiring ongoing surveillance and intervention.
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