Human plague: An old scourge that needs new answers

Area of Science:

• Zoonotic diseases
• Epidemiology
• Microbiology

Background:

• Yersinia pestis causes plague, a re-emerging zoonotic disease with significant historical and current public health impact.
• Plague outbreaks, like the 2017 urban pneumonic plague in Madagascar, highlight its persistent threat and potential for epidemics.
• The disease's resilience, high fatality rate without prompt treatment, and societal disruption necessitate a re-evaluation of its status as a neglected threat.

Purpose of the Study:

• To review current knowledge on plague (Yersinia pestis).
• To identify critical scientific research priorities for eradicating plague as a human threat.
• To foster a global control and prevention strategy using a "One Health" approach.

Main Methods:

• A workshop convened experts in July 2018 in Paris.
• Discussions focused on reviewing existing plague research and identifying knowledge gaps.
• Research priorities were structured around four key thematic axes.

Main Results:

• An urgent need for a funded research agenda was identified.
• Key research areas include: ecological interactions (reservoir, vector, pathogen, environment), human and societal responses, improved diagnostics and case management, and vaccine development.
• Proposed research should be cross-cutting, translational, and context-specific.

Conclusions:

• A coordinated and well-funded research agenda is essential to address knowledge gaps in plague.
• The identified research axes provide a framework for developing effective, context-specific control and prevention strategies.
• Implementing these strategies within a "One Health" framework is crucial for global plague eradication efforts.