Plague Gives Surprises in the Second Decade of the Twenty-First Century

Thomas Butler Ross University School of Medicine, Bridgetown, Barbados, West Indies, Retired

Search for other papers by Thomas Butler in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

From 2010 through 2019, the six leading countries by numbers of human plague cases reported to the WHO were, in order from highest to lowest, Madagascar, Congo, Uganda, Peru, Tanzania, and the United States. From these countries, there was a total of 4,547 cases, of whom 786 (17%) died. Top plague events were four outbreaks of primary pneumonic plague in Madagascar that affected 1,936 persons, including index cases, of whom 137 died. One of the outbreaks was caused by a streptomycin-resistant strain of Yersinia pestis. Person-to-person transmission occurred in a taxi, in households with family caregivers, at burial ceremonies and wakes for victims, and at a hospital where cases were treated. Unique clinical presentations in the United States included a dog owner who acquired pneumonic plague from his sick dog, a boy with septicemic plague who developed complications of osteomyelitis and arthritis that required surgery for bone removal and bone grafting, and a prairie dog handler who acquired bubonic plague from a bite by a sick prairie dog. Efficacy of antibiotics in a model of pneumonic plague in African green monkeys for use in bioterrorism revealed the most effective drugs to be gentamicin, ciprofloxacin, and levofloxacin. A recombinant vaccine containing Fraction 1 antigen and V antigen of Y. pestis designed for first responders during a bioterrorism attack and military personnel was tested for safety and immunogenicity but was not licensed for use by the end of the decade.

Author Notes

Author’s address: Thomas Butler, 1045 Spencer St., Allen, TX, E-mail: tomxanadu@gmail.com.

Address correspondence to Thomas Butler, 1045 Spencer St., Allen, TX 75013. E-mail: tomxanadu@gmail.com
  • 1.

    Valies X et al., 2020. Human plague: an old scourge that needs new answers. PLoS Negl Trop Dis 14: e0008251.

  • 2.

    Barbieri R, Signoli M, Cheve D, Costedoat C, Tzortzis S, Aboudharam G, Raoult D, Drancourt M, 2020. Yersinia pestis: the natural history of plague. Clin Microbiol Rev 34: e00044e19.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Butler T, 2013. Plague gives surprises in the first decade of the 21st century in the United States and worldwide. Am J Trop Med Hyg 89: 788793.

  • 4.

    Bertherat E, 2016. Plague around the world, 2010–2015. Wkly Epidemiol Rec 91: 89104.

  • 5.

    Bertherat E, 2019. Plague around the world in 2019. Wkly Epidemiol Rec 94: 289292.

  • 6.

    Randremanana R et al., 2019. Epidemiological characteristics of an urban plague epidemic in Madagascar, August–November, 2017: an outbreak report. Lancet Infect Dis 19: 537545.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Richard V, Riehm JM, Herindrainy P, Soanandrasana R, Ratsitoharina M, Rakotomanana F, Andrianalimanana S, Scholz HC, Rajerison M, 2015. Pneumonic plague outbreak, northern Madagascar, 2011. Emerg Infect Dis 21: 815.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Ramasindrazana B, Andrianaivoarimanana V, Rakotondramanga JM, Birdsell DN, Rasitorahina M, Rajerison M, 2017. Pneumonic plague transmission, Moramanga, Madagascar, 2015. Emerg Infect Dis 23: 521524.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Runfola JK et al., 2015. Outbreak of human pneumonic plague with dog-to-human and possible human-to-human transmission – Colorado, June–July 2014. MMWR Morb Mortal Wkly Rep 64: 429434.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Nichols MC, Ettestad PJ, VinHatton ES, Melman SD, Onischuk L, Pierce EA, Aragon AS, 2014. Yersinia pestis infection in dogs: 62 cases (2003–2011). J Am Vet Med Assoc 244: 11761180.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Padua LT et al., 2017. Unique case of disseminated plague with multifocal osteomyelitis. J Pediatric Infect Dis Soc 6: e165e168.

  • 12.

    Danforth M et al., 2016. Investigation of and response to 2 plague cases, Yosemite National Park, California, USA, 2015. Emerg Infect Dis 22: 20452053.

  • 13.

    Melman SD et al., 2018. Human case of bubonic plague resulting from the bite of a wild Gunnison’s prairie dog during translocation from a plague-endemic area. Zoonoses Pub Hlth 65: e254e258.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Apangu T et al., 2017. Successful treatment of human plague with oral ciprofloxacin. Emerg Infect Dis 23: 553555.

  • 15.

    Andrianaivoarimanana V et al., 2022. Transmission of antimicrobial resistant Yersinia pestis during a pneumonic plague outbreak. Clin Infect Dis 74: 695702.

  • 16.

    Hewitt JA, Lanning JL, Campbell JL, 2020. The African green monkey model of pneumonic plague and US Food and Drug Administration approval under the animal rule. Clin Infect Dis 70: S51S59.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Price JL, Manetz TS, Shearer JD, House RV, 2013. Preclinical safety assessment of a recombinant plague vaccine (rF1V). Int J Toxicol 32: 327335.

  • 18.

    Fellows P, Price J, Martin S, Metcalfe K, Krile R, Barnewall R, Hart MK, Lockman H, 2015. Characterization of a cynomolgus macaque model of pneumonic plague for evaluation of vaccine efficacy. Clin Vaccine Immunol 22: 10701078.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Chu K et al., 2016. Immunogenicity and safety of a subunit plague vaccine: a randomized phase 2a clinical trial. Hum Vaccin Immunother 12: 23342340.

  • 20.

    Gage KL, Dennis DT, Orloski KA, Ettestad P, Brown TL, Reynolds PJ, Pape WJ, Fritz CL, Carter LG, Stein JD, 2000. Cases of cat-associated human plague in the western US, 1977–1998. Clin Infect Dis 30: 893900.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Wang H et al., 2011. A dog-associated case of primary pneumonic plague in Qinhai Province, China. Clin Infect Dis 52: 185190.

  • 22.

    Heine HS, Hershfield J, Marchand C, Miller L, Halasohoris S, Purcell BK, Worsham PL, 2015. In vitro antibiotic susceptibilities of Yersinia pestis determined by broth microdilution following CLSI methods. Antimicrob Agents Chemother 59: 19191921.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Kugeler KJ, Mead PS, Campbell SB, Nelson CA, 2020. Antimicrobial treatment patterns and illness outcome among United States patients with plague, 1942–2018. Clin Infect Dis 70: S20S26.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1261 1260 274
Full Text Views 146 146 20
PDF Downloads 86 86 23
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save