A major new test for plague

Abstract

In 1894, Alexandre Yersin, a student of Pasteur, first identified the plague bacillus in buboes of corpses in Hong Kong. 1 Bibel DJ Chen TH Diagnosis of plague: an analysis of the Yersin-Kitasato controversy. Bacteriol Rev. 1976; 40: 633-651 PubMed Google Scholar This finding occurred at the beginning of the third plague pandemic, which caused more than 25 million cases and left 12 million dead worldwide. Yersin and other early plague workers used staining, culture, and serology to identify infection with the causative agent, ultimately named Yersinia pestis. Although these classic methods have continued to be diagnostic mainstays for clinical and epidemiological purposes, they lack sensitivity and timeliness (confirmation of infection may take weeks), and are often inapplicable in the remote rural areas where most of the world's 3000–4000 annually reported plague cases occur. 2 WHO Human plague in 1998 and 1999. Wkly Epidemiol Rec. 2000; 75: 338-339 PubMed Google Scholar The “plague emergency” in India in 1994 highlighted the confusion and costs that can result from inadequate laboratory diagnostics. 3 Campbell GL Hughes JM Plague in India: a new warning from an old nemesis. Ann Intern Med. 1995; 122: 151-153 Crossref PubMed Scopus (52) Google Scholar Still, nearly 10 years on, production of plague diagnostic reagents and experienced and reliable testing is with few exceptions limited to a small number of WHO collaborating centres. The growing concern over bioterrorism further highlights deficiencies in plague testing. 4 Inglesby TV Dennis DT Henderson DA et al. Plague as a biological weapon: medical and public health management. JAMA. 2000; 283: 2281-2290 Crossref PubMed Scopus (839) Google Scholar The critical need is for simple, rapid, and reliable assays to support the clinical diagnosis of an acutely ill patient for whom early specific treatment is essential for survival, and to provide timely information necessary to control spread of the disease. Development and testing of a rapid diagnostic test for bubonic and pneumonic plagueOur RDT is a specific, sensitive, and reliable test that can easily be done by health workers at the patient's bedside, for the rapid diagnosis of pneumonic and bubonic plague. This test will be of key importance for the control of plague in endemic countries. Full-Text PDF