Abstract
We analyzed epidemiologic characteristics and distribution of 1,067 human plague cases and 5,958 Yersinia pestis isolates collected from humans, host animals, and insect vectors during 1950–2019 in 4 Marmota plague foci in China. The case-fatality rate for plague in humans was 68.88%; the overall trend slowly decreased over time but fluctuated greatly. Most human cases (98.31%) and isolates (82.06%) identified from any source were from the Marmota himalayana plague focus. The tendency among human cases could be divided into 3 stages: 1950–1969, 1970–2003, and 2004–2019. The Marmota sibirica plague focus has not had identified human cases nor isolates since 1926. However, in the other 3 foci, Y. pestis continues to circulate among animal hosts; ecologic factors might affect local Y. pestis activity. Marmota plague foci are active in China, and the epidemic boundary is constantly expanding, posing a potential threat to domestic and global public health.
Highlights
We analyzed epidemiologic characteristics and distribution of 1,067 human plague cases and 5,958 Yersinia pestis isolates collected from humans, host animals, and insect vectors during 1950–2019 in 4 Marmota plague foci in China
Since the 1990s, rat-associated plague epidemics have erupted in southern China, but beginning in 2004, the Marmota himalayana plague focus re-emerged as the main source of human cases
We investigated the distribution and characteristics of human plague cases and Y. pestis isolates recovered from animal hosts and insect vectors during 1950–2019
Summary
We analyzed epidemiologic characteristics and distribution of 1,067 human plague cases and 5,958 Yersinia pestis isolates collected from humans, host animals, and insect vectors during 1950–2019 in 4 Marmota plague foci in China. Most human cases (98.31%) and isolates (82.06%) identified from any source were from the Marmota himalayana plague focus. The Marmota sibirica plague focus has not had identified human cases nor isolates since 1926. Zhang); Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot, China The Marmota himalayana plague focus is the largest and the most active foci in China. This focus covers >443,290 km and, before the 1990s, most human cases occurred here. Since the 1990s, rat-associated plague epidemics have erupted in southern China, but beginning in 2004, the Marmota himalayana plague focus re-emerged as the main source of human cases.
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