Abstract
Plague is an ancient, serious, infectious disease which is still endemic in regions of the modern world and is a potential biothreat agent. This paper discusses the natural history of the bacterium and its evolution into a flea-vectored bacterium able to transmit bubonic plague. It reviews the incidence of plague in the modern world and charts the history of vaccines which have been used to protect against the flea-vectored disease, which erupts as bubonic plague. Current approaches to vaccine development to protect against pneumonic, as well as bubonic, plague are also reviewed. The considerable challenges in achieving a vaccine which is licensed for human use and which will comprehensively protect against this serious human pathogen are assessed.
Highlights
Plague is an ancient, serious, infectious disease which is still endemic in regions of the modern world and is a potential biothreat agent
This paper discusses the natural history of the bacterium and its evolution into a flea-vectored bacterium able to transmit bubonic plague
It reviews the incidence of plague in the modern world and charts the history of vaccines which have been used to protect against the flea-vectored disease, which erupts as bubonic plague
Summary
Acquired plasmids: pPst/pPCP/pPla, pFra/pMT1 plasmids yadA inv (colonization, dissemination) Inactivated hms (biofilm formation) Inactivated O-antigen genes (dampens host response and permits Pla function). Immunization with rF1/V has been shown to protect animal models against fleavectored plague (Jarrett et al, 2004) as well as against experimental exposure to Y. pestis (Powell et al, 2005; Williamson et al, 1997). A number of studies have demonstrated that rF1 and rV in combination, or genetically fused (rF1–V), constitute an efficacious vaccine which has been shown to protect macaques against inhalational challenge with Y. pestis, providing a real prospect for a vaccine effective against pneumonic plague (Table 1). As a genetic fusion, they are potently immunogenic and protective, most critically against pneumonic plague This sets the experimental rF1/V vaccine apart from the previous killed wholecell vaccines, which have been demonstrated to protect animal models against injected challenge with Y. pestis, but which cannot protect against inhaled challenge (Williamson et al, 1997). The differential between live attenuated and killed vaccines in efficacy against pneumonic plague has been attributed to http://jmm.sgmjournals.org
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