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A forensic evaluation of plague - a re-emerging infectious disease with biowarfare potential
1School of Medicine, The University of Adelaide, Australia.
Abstract:
Plague is an acute infectious disease caused by the gram-negative cocco-bacillus Yersinia pestis. It has been responsible for 200 million deaths throughout history with three major pandemics. There are three forms: bubonic, septicaemic and pneumonic, each carrying a significant mortality rate. The usual transmission is from fleas carried by rodents. Recently, it has been listed as one of the reemerging infectious diseases globally, with a potential use in bioterrorism. At autopsy there may be lymphadenopathy, fulminant pneumonia or diffuse interstitial pneumonitis. However any organ may be affected with myocarditis, meningitis, pharyngitis and hepatic and splenic necrosis. The lethality of plague with the resurgence in numbers of cases, development of antibiotic resistance, recent occurrence in urban areas and the lack of a vaccine make it a disease not to be missed in the mortuary.
Insights
Plague, caused by Yersinia pestis, is a deadly reemerging infectious disease. Its various forms and potential for bioterrorism necessitate vigilance, especially in mortuary settings.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Plague is an acute, highly fatal infectious disease caused by Yersinia pestis.
- Historically, plague caused three major pandemics, resulting in an estimated 200 million deaths.
- It presents in three primary forms: bubonic, septicemic, and pneumonic.
Observation:
- Transmission typically occurs via fleas from infected rodents.
- Yersinia pestis can affect multiple organs, leading to lymphadenopathy, pneumonia, myocarditis, meningitis, and necrosis.
- Autopsy findings may include fulminant pneumonia or diffuse interstitial pneumonitis.
Findings:
- Plague is considered a reemerging infectious disease with potential bioterrorism applications.
- Recent outbreaks have occurred in urban settings, highlighting its continued threat.
- Antibiotic resistance and the absence of a vaccine contribute to its significant mortality rate.
Implications:
- The resurgence of plague cases and its potential use as a bioweapon underscore the need for ongoing surveillance.
- Understanding the diverse pathological manifestations is crucial for accurate diagnosis in clinical and forensic settings.
- Given its lethality and evolving resistance patterns, plague remains a critical public health concern, particularly in mortuary identification.
