Abstract
Pneumonic plague outbreaks are relatively infrequent in modern times, but in the early part of the 20th century, they were commonplace including several well-documented epidemics responsible for the deaths of thousands. The transmissibility of this disease seems to be discontinuous since in some outbreaks few transmissions occur, while in others, the progression of the epidemic is explosive. Modern epidemiological studies explain that transmissibility within populations is heterogenous with relatively few subjects likely to be responsible for most transmissions and that ‘super spreading events’, particularly at the start of an outbreak, can lead to a rapid expansion of cases. These findings concur with outbreaks observed in real-world situations. It is often reported that pneumonic plague is rare and not easily transmitted but this view could lead to unnecessary complacency since future risks such as the spontaneous incidence of anti-microbial strains, climate change leading to a disruption of natural cycles within plague foci and use of plague as a bioweapon cannot be discounted. Carers and first responders are vulnerable, particularly in poorer countries where access to medicines and protection equipment may be limited, outbreaks occur in inaccessible areas or where there is a lack of surveillance due to a paucity of funds.
Highlights
It seems evident that in the early part of the 20th Century, Pneumonic plague (PP) epidemics were not rare but occurred frequently around the globe. During this period several substantial epidemics, involving the death of several thousands of people, took place in India, Manchuria, China and West Africa none of these progressed into a distinct global pandemic
There has been a relative quiescence in plague during the latter part of the 20th Century but the outbreaks of PP in Surat, 1994 and Madagascar, 2017 are a reminder to us of the potential for this disease to re-emerge
When considering the transmissibility of PP, the situation is complex, as it is with other respiratory diseases, but in the real world there are two factors which limit the ease with which spread can occur compared to viral infections
Summary
Bubonic plague is famously characterised by swellings of the lymphatic glands known as buboes and is usually the result of transmission from an infected rodent host, via an insect vector In this form plague is not readily transmittable from person-to-person some workers believe that human ectoparasites, such as lice or fleas, can play a role under certain circumstances [5]. Septicemic plague, is characterised by high bacteraemia, without evidence of lymphatic swellings, usually resulting in overwhelming endotoxemia that is fatal if untreated promptly In this case, the primary infection site is often a flea bite but the disease rapidly progresses to the septicaemic form if the lymphatic defences are breached [6]. This paper seeks to review the evidence which might predict the likelihood of PP outbreaks in the future and, if they do arise, how will Yp transmit in a human population
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
