Abstract
Plague is an acute bacterial infection of man caused by Yersinia pestis. The natural reservoirs of the organism are predominantly urban and sylvatic rodents, and it is transmitted among animals and occasionally to man by bites of infected fleas. Plague has a cosmopolitan distribution with significant foci of infection in the Americas, Africa, and Asia. Y. pestis has caused devastating pandemics throughout history with high mortality rates, in which pneumonic man-to-man transmission has occurred in addition to the usual flea-to-man spread. Today, in the United States, urban plague carried by rats has been eliminated, but sylvatic plague persists in rodents and other mammals of rural areas in the southwestern states with occasional transmission to man. The most common clinical form is acute regional lymphadenitis, called bubonic plague. Less common forms include septicemic, pneumonic, and meningeal plague. Mortality is high in untreated patients, but antibiotic treatment with streptomycin administered early in the course of disease markedly reduces fatalities.
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