Abstract
Plague, caused by the bacterium Yersinia pestis, is one of the deadliest infectious diseases in human history, and still causes worrying outbreaks in Africa and South America. Despite the historical and current importance of plague, several questions remain unanswered concerning its transmission routes and infection risk factors. The plague outbreak that started in September 1665 in the Derbyshire village of Eyam claimed 257 lives over 14 months, wiping out entire families. Since previous attempts at modelling the Eyam plague, new data have been unearthed from parish records revealing a much more complete record of the disease. Using a stochastic compartmental model and Bayesian analytical methods, we found that both rodent-to-human and human-to-human transmission played an important role in spreading the infection, and that they accounted, respectively, for a quarter and three-quarters of all infections, with a statistically significant seasonality effect. We also found that the force of infection was stronger for infectious individuals living in the same household compared with the rest of the village. Poverty significantly increased the risk of disease, whereas adulthood decreased the risk. These results on the Eyam outbreak contribute to the current debate on the relative importance of plague transmission routes.
Highlights
Plague, caused by the bacterium Yersinia pestis, has been one of the most deadly infectious diseases throughout human existence
The once debated question of the causative agent of the Black Death has been confirmed beyond doubt by the identification of Y. pestis DNA from victim remains [6,7,8], and likewise for the Justinian Plague [9,10]
We found evidence for both rodentto-human and human-to-human transmission routes, with these two routes accounting, respectively, for a quarter and three-quarters of all infection cases
Summary
Plague, caused by the bacterium Yersinia pestis, has been one of the most deadly infectious diseases throughout human existence. There have only been a few attempts to model the epidemiology of the Eyam plague [34,35,36] These previous studies have relied on local historian William Wood’s account of the village’s demography, who, writing about a century after the event, placed the population at around 350 people and the mortality rate at close to 75% [28]. A complex compartmental model with 38 set par- 2 ameters has more recently been proposed [36], which considered human, rat and flea population dynamics, but assumed perfect mixing of a population with an underestimated size of 350 people [28] and no latent period of infection. The combination of more detailed data with a novel model, enables us to shed new light on the transmission of the Eyam plague outbreak of 1665–1666, which feeds directly into the debate surrounding the epidemiology of historical plague
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