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Yersinia pestis: the Natural History of Plague.

Authors
  • Barbieri, R1, 2, 3
  • Signoli, M2
  • Chevé, D2
  • Costedoat, C2
  • Tzortzis, S4
  • Aboudharam, G1, 5
  • Raoult, D1, 3
  • Drancourt, M6, 3
  • 1 Aix-Marseille University, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France. , (France)
  • 2 Aix-Marseille University, CNRS, EFS, ADES, Marseille, France. , (France)
  • 3 Fondation Méditerranée Infection, Marseille, France. , (France)
  • 4 Ministère de la Culture, Direction Régionale des Affaires Culturelles de Provence-Alpes-Côte d'Azur, Service Régional de l'Archéologie, Aix-en-Provence, France. , (France)
  • 5 Aix-Marseille University, Faculty of Odontology, Marseille, France. , (France)
  • 6 Aix-Marseille University, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France [email protected] , (France)
Type
Published Article
Journal
Clinical Microbiology Reviews
Publisher
American Society for Microbiology
Publication Date
Dec 16, 2020
Volume
34
Issue
1
Identifiers
DOI: 10.1128/CMR.00044-19
PMID: 33298527
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The Gram-negative bacterium Yersinia pestis is responsible for deadly plague, a zoonotic disease established in stable foci in the Americas, Africa, and Eurasia. Its persistence in the environment relies on the subtle balance between Y. pestis-contaminated soils, burrowing and nonburrowing mammals exhibiting variable degrees of plague susceptibility, and their associated fleas. Transmission from one host to another relies mainly on infected flea bites, inducing typical painful, enlarged lymph nodes referred to as buboes, followed by septicemic dissemination of the pathogen. In contrast, droplet inhalation after close contact with infected mammals induces primary pneumonic plague. Finally, the rarely reported consumption of contaminated raw meat causes pharyngeal and gastrointestinal plague. Point-of-care diagnosis, early antibiotic treatment, and confinement measures contribute to outbreak control despite residual mortality. Mandatory primary prevention relies on the active surveillance of established plague foci and ectoparasite control. Plague is acknowledged to have infected human populations for at least 5,000 years in Eurasia. Y. pestis genomes recovered from affected archaeological sites have suggested clonal evolution from a common ancestor shared with the closely related enteric pathogen Yersinia pseudotuberculosis and have indicated that ymt gene acquisition during the Bronze Age conferred Y. pestis with ectoparasite transmissibility while maintaining its enteric transmissibility. Three historic pandemics, starting in 541 AD and continuing until today, have been described. At present, the third pandemic has become largely quiescent, with hundreds of human cases being reported mainly in a few impoverished African countries, where zoonotic plague is mostly transmitted to people by rodent-associated flea bites. Copyright © 2020 American Society for Microbiology.

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