Abstract
Along with other countries in America, plague reached Brazil through the sea routes during the third pandemic. A brief ports phase was followed by an urban phase that took place in smaller inland cities and finally, it attained the rural area and established several foci where the ecological conditions were suitable for its continued existence. However, the geographic dispersion of plague in Brazil is still poorly studied. To better understand the disease dynamics, we accessed satellite-based data to trace the spatial occurrence and distribution of human plague cases in Pernambuco, Northeastern Brazil and using the municipality of Exu as study case area. Along with the satellite data, a historical survey using the Plague Control Program files was applied to characterize the spatial and temporal dispersion of cases in the period of 1945-1976. Kernel density estimation, spatial and temporal clusters with statistical significance and maximum entropy modeling were used for spatial data analysis, by means of the spatial analysis software packages. The use of geostatistical tools allowed evidencing the shift of the infection from the urban to the wild-sylvatic areas and the reemergence of cases after a period of quiescence, independent of the reintroduction from other plague areas.
Highlights
Plague is a focal zoonosis, affecting primarily rodents and eventually, humans and other mammals
There was a marked presence of two significant spatiotemporal clusters obtained by the scanning map (Scan) analysis, one with a long survival rate located in the northern part of the municipality with LLR = 1.62 in the period 1968–1974 and the other with short survival rate located in the part south of the municipality with LLR = 1.04 in the period 1969–1975. These results demonstrate the higher prevalence of the plague in the rural areas during this second epidemic period in Exu
During the studied period it was demonstrated the transition of the infection from the urban to the rural areas in Exu, Pernambuco state, Northeast of Brazil and the reemergence of cases after a quiescence period without reintroduction from other foci
Summary
Plague is a focal zoonosis, affecting primarily rodents and eventually, humans and other mammals. The infection spectrum is wide and the main presentations are the bubonic, pneumonic and septicemic forms; the contamination occurs mainly through flea bites, inhalation of aerosols or contact with infected secretions or tissues [1]. It is caused by Yersinia pestis, a Gramnegative bacillus that belong to the Enterobacteriaceae family [2] and is categorized in the Biohazard Class 3 and Bioterrorism Agents Group A [3]. Spatiotemporal analysis of plague in Pernambuco, Brazil confirmed plague cases in the State of Pernambuco, including dates, locations and the coordinates for each municipality affected
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