Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 66 (1), 18-26

Plague: History and Contemporary Analysis

Affiliations
Review

Plague: History and Contemporary Analysis

Didier Raoult et al. J Infect.

Abstract

Plague has caused ravaging outbreaks, including the Justinian plague and the "black death" in the Middle Ages. The causative agents of these outbreaks have been confirmed using modern molecular tests. The vector of plague during pandemics remains the subject of controversy. Nowadays, plague must be suspected in all areas where plague is endemic in rodents when patients present with adenitis or with pneumonia with a bloody expectorate. Diagnosis is more difficult in the situation of the reemergence of plague, as in Algeria for example, told by the first physician involved in that outbreak (NM). When in doubt, it is preferable to prescribe treatment with doxycycline while waiting for the test results because of the risk of fatality in individuals with plague. The typical bubo is a type of adenitis that is painful, red and nonfluctuating. The diagnosis is simple when microbiological analysis is conducted. Plague is a likely diagnosis when one sees gram-negative bacilli in lymph node aspirate or biopsy samples. Yersinia pestis grows very easily in blood cultures and is easy to identify by biochemical tests and MALDI-TOF mass spectrometry. Pneumonic plague and septicemic plague without adenitis are difficult to diagnose, and these diagnoses are often made by chance or retrospectively when cases are not part of an epidemic or related to another specific epidemiologic context. The treatment of plague must be based on gentamicin or doxycycline. Treatment with one of these antibiotics must be started as soon as plague is suspected. Analysis of past plague epidemics by using modern laboratory tools illustrated the value of epidemic buboes for the clinical diagnosis of plague; and brought new concepts regarding its transmission by human ectoparasites.

Similar articles

See all similar articles

Cited by 7 PubMed Central articles

  • Model-based Analysis of an Outbreak of Bubonic Plague in Cairo in 1801
    X Didelot et al. J R Soc Interface 14 (131). PMID 28637916.
    Bubonic plague has caused three deadly pandemics in human history: from the mid-sixth to mid-eighth century, from the mid-fourteenth to the mid-eighteenth century and fro …
  • Successful Treatment of Human Plague With Oral Ciprofloxacin
    T Apangu et al. Emerg Infect Dis 23 (3), 553-555. PMID 28125398. - Clinical Trial
    The US Food and Drug Administration recently approved ciprofloxacin for treatment of plague (Yersina pestis infection) based on animal studies. Published evidence of effi …
  • Yersinia Pestis Halotolerance Illuminates Plague Reservoirs
    MA Malek et al. Sci Rep 7, 40022. PMID 28054667.
    The plague agent Yersinia pestis persists for years in the soil. Two millennia after swiping over Europe and North Africa, plague established permanent foci in North Afri …
  • Plague in Arab Maghreb, 1940-2015: A Review
    MA Malek et al. Front Public Health 4, 112. PMID 27376053. - Review
    We reviewed the epidemiology of 49 plague outbreaks that resulted in about 7,612 cases in 30 localities in the Arabic Maghreb (Mauritania, Morocco, Algeria, Tunisia, Liby …
  • Epidemiological Analysis of the Eyam Plague Outbreak of 1665-1666
    LK Whittles et al. Proc Biol Sci 283 (1830). PMID 27170724.
    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 Ame …
See all "Cited by" articles

MeSH terms

Substances

LinkOut - more resources

Feedback