The plague

The plague has been one of the most devastating diseases of human history. Despite major advances in diagnosis, prevention, and treatment, it has not been possible to eradicate this infection. Plague is still active in Africa, in Asia and in the Americas, and is classified as a currently re-emerging disease. The plague is mainly a disease of rodents, which is transmitted by fleabites. Humans develop two main clinical forms: bubonic plague (following bites of infected fleas, lethal in 50-70% of the cases in less than a week if an appropriate treatment is not started rapidly), and pneumonic plague (after inhalation of infected droplets, lethal in less than three days in 100% of cases without immediate treatment). Y. pestis, the causative agent of plague, is usually sensitive to most antibiotics, but the first multi-resistant strain was recently described. No efficient and safe vaccines are currently available. The plague bacillus is one of the few organisms that could be used for biological warfare.     

鼠疫

鼠疫是危害人类最严重的烈性传染病之一,仍是对人类生命健康、社会经济发展影响最为重要的公共卫生问题。阐述了世界和中国鼠疫自然疫源地的分布、动物鼠疫流行病学、中国鼠疫自然疫源地类型及动物流行病学特点、人类鼠疫流行病学和防治。     

鼠疫的流行病学概述

鼠疫是由鼠疫耶尔森菌(Yersinia pestis)引起严重危害人类健康的烈性传染病。本文介绍了鼠疫病原体——鼠疫耶尔森菌的一般特性及生物学特性, 并对国内、外鼠疫疫情现状进行总结。目前鼠疫在全球范围内的流行已进入新的活跃期,世界卫生组织将鼠疫列为近20年来重新流行的急性传染病之一。当前,全球疫区主要分布在非洲、亚洲和南美洲。我国人间鼠疫自20世纪80年代开始处于明显回升势态,近10年流行逐渐下降,但防控形势依然艰巨。     

Transmission of crayfish plague

Two possible means of transmission of crayfish plague were investigated: via fish (as vectors), and via crayfish (as hosts or vectors when dead). The crayfish transmission experiments focussed on both the viability of the fungus in dead crayfish when kept in simulated field conditions, and on the treatments which kill viable forms of Aphanomyces astaci within the recently dead host (cadaver). It was found that A. astaci remains viable for 5 d, and possibly longer in crayfish kept in water at 21 degrees C after dying of crayfish plague. Heating (boiling for 1 min) was the quickest way of decontaminating crayfish cadavers. Freezing took considerably longer: after 48 h at -20 degrees C, viable stages were still present. It was also found that A. astaci is unlikely to survive passage of the gastrointestinal tract of either mammals or birds as no viable stages were found after 12 h at 37 degrees C. Two basic modes of transmission of crayfish plague via fish were investigated: (1) after passage of initially viable forms of A. astaci through the digestive tract of fish and (2) via fish skin. If A. astaci was fed to fish as infected abdominal cuticle, it was still viable after passage through the gastrointestinal tract. When pure mycelium or spores were fed to fish there was no indication of viable forms of A. astaci after passage through the gastrointestinal tract. Transmission via fish skin was not observed under the experimental conditions applied. The results on fish as vectors have practical importance for fish transport and stocking because the present study shows that there is a risk of transmission of crayfish plague via fish faeces. The investigation of crayfish as vectors delivers methods that could be used for treatment of crayfish imported for human consumption into crayfish-plague-free areas. This application is particularly important for the importation of American crayfish, which are in general suspected to carry A. astaci in their cuticle.     

Doxycycline in the prevention of experimental plague induced by plague microbe variants]

A comparative study was performed on the efficacy of doxycycline in experimental plague infection induced in albino mice by strain 231 of the plague microbe and its variant 231 Fra- deprived of the ability to produce the fraction I antigen. It was shown that the LD50 for strain 231 during animal treatment with doxycycline was significantly higher than that for variant 231 Fra-. Prophylaxis of the plague infection caused by the Fra- forms of the plague microbe required significantly higher doses of doxycycline (ED50) than that of the infection caused by the Fra+ forms. The use of the daily maximum permissible doses of doxycycline (50 to 100 mg/kg a day) for 10 days in treatment of albino mice infected with the strain Fra- did not provide animal survival at the level higher than 60 to 70 per cent while the survival rate in the animals infected with the strain Fra+ of the plague microbe and treated according to the same scheme amounted to 90-100 per cent. The lower therapeutic efficacy of doxycycline in the treatment of the infection caused by the fractionless variant of the plague microbe should be considered in development of rational schemes for prophylaxis and treatment of plague.     

The epidemiologic classification of plague morbidity

On the basis of the analysis of plague morbidity in the world in the XX century all epidemic foci are subdivided into 3 groups: primary, indirect primary and secondary. Each group is characterized by its specific type of morbidity in accordance with infective factors: factors connected with the natural foci of infection in group 1, economic and synanthropic factors, as well as laboratory infections, in group 2 and anthroponotic factors in group 3. In its turn, each type of morbidity differs in routes, sources, mechanisms and clinical forms of infection. In accordance with the conditions of infection, the natural foci of plague can be subdivided into mono-, oligo- and multifactor foci. The typing of plague morbidity facilitates more target-oriented organization of antiplague measures.