[The resurgence of the plague]

Plague was one of the most devastating diseases of human history until vaccination and antibiotic therapy considerably reduced the number of cases. Nowadays plague tends to be considered a disease of ancient times. However the disease has never disappeared and persists in its animal reservoir. Natural endemic foci still remain in three continents and other foci that were considered cleared of plague re-emerge. Plague importation may also occur everywhere in the world. The two main clinical forms are the bubonic plague and the pneumonic plague. If not treated by appropriate antibiotics, the mortality rate is 40-70% for the bubonic form and 100% for the pneumonic form. A prompt clinical diagnosis is essential. If plague is suspected, antibiotics are given immediately after clinical samples are taken and diagnosis is confirmed by the presence of Yersinia pestis in the samples.