Can we make human plague history? A call to action

• Published in: BMJ global health Vol. 4; no. 6; p. e001984
• Main Authors: Baril, Laurence, Vallès, Xavier, Stenseth, Nils Christian, Rajerison, Minoarisoa, Ratsitorahina, Maherisoa, Pizarro-Cerdá, Javier, Demeure, Christian, Belmain, Steve, Scholz, Holger, Girod, Romain, Hinnebusch, Joseph, Vigan-Womas, Ines, Bertherat, Eric, Fontanet, Arnaud, Yazadanpanah, Yazdan, Carrara, Guia, Deuve, Jane, D'ortenzio, Eric, Angulo, Jose Oswaldo Cabanillas, Mead, Paul, Horby, Peter W
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2019; BMJ Publishing Group Ltd; BMJ Publishing Group
• Subjects: Adaptive immunology; Allergology; Antibiotics; Antigens; Bacteriology; Cooperation; Disease prevention; Drug resistance; Epidemics; Epidemiology; Global health; Human health and pathology; Immunology; Infectious diseases; Innate immunity; Life Sciences; Microbiology and Parasitology; Pathogens; Public health; Vaccines; Vaccinology; Madagascar; Africa; epidemiology; public health
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2019-001984

During the 14th century, the Black Death, caused by Y. pestis, is estimated to have killed 30%–40% of the European population.1 It is important to emphasise that human plague is mostly a poverty-related disease. [...]given that population density and the absolute number of people living in extreme poverty are both increasing in sub-Saharan Africa,6 there is no likelihood of plague being eliminated as a public health threat in the foreseeable future. Improved understanding of host–vector–pathogen interplay Given the extraordinary ability of Y. pestis to adapt and colonise different environments, host reservoirs and vectors, and to re-emerge8 the elimination of plague among wildlife species is judged almost impossible. [...]the focus should be put to prevent human transmission. Early and accurate diagnosis of pulmonary plague cases is critical for detecting and controlling outbreaks, because pneumonic plague is the most lethal form of the disease. [...]serious consequences can arise from both false-negative and false-positive results. [...]treating a large number of patients with streptomycin in the context of an outbreak can be a major challenge. Since it is no longer used as a first-line treatment of tuberculosis, streptomycin is not widely available, and its distribution may cease within a few years.