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Human plague: An old scourge that needs new answers

Xavier Vallès 1, * Nils Stenseth 2, 3 Christian Demeure 4 Peter Horby 5 Paul Mead 6 Oswaldo Cabanillas 7 Mahery Ratsitorahina 1 Minoarisoa Rajerison 8 Voahangy Andrianaivoarimanana 8 Beza Ramasindrazana 8 Javier Pizarro-Cerdá 4 Holger Scholz 9 Romain Girod 10 B. Joseph Hinnebusch 11 Inès Vigan-Womas 12 Arnaud Fontanet 13, 14, 15 David Wagner 16 Sandra Telfer 17 Yazdan Yazdanpanah 18, 19 Pablo Tortosa 20 Guia Carrara 18 Jane Deuve 21 Steven Belmain 22 Eric d'Ortenzio 18, 19 Laurence Baril 1
* Corresponding author
1 Institut Pasteur de Madagascar
2 CEES - Centre for Ecological and Evolutionary Synthesis
3 THU - Tsinghua University [Beijing]
4 Yersinia
5 University of Oxford [Oxford]
6 Centers for Disease Control and Prevention
7 Oficina General de Epidemiologia [Lima, Peru]
8 Unité Peste - Plague Unit [Antananarivo, Madagascar]
9 Bundeswehr Institute of Microbiology
10 IPM - Unité d'Entomologie Médicale [Antananarivo, Madagascar]
11 Rocky Mountain Laboratories
12 IPM - Unité d'immunologie des maladies infectieuses [Antananarivo, Madagascar]
13 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
14 PACRI - Pasteur-Cnam Risques infectieux et émergents
15 CNAM - Conservatoire National des Arts et Métiers [CNAM]
16 Northern Arizona University [Flagstaff]
17 University of Aberdeen
18 REACTing
19 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
20 PIMIT - Processus Infectieux en Milieu Insulaire Tropical
21 Institut Pasteur [Paris]
22 Natural Resources Institute [Chatham]
Abstract : Yersinia pestis, the bacterial causative agent of plague, remains an important threat to human health. Plague is a rodent-borne disease that has historically shown an outstanding ability to colonize and persist across different species, habitats, and environments while provoking sporadic cases, outbreaks, and deadly global epidemics among humans. Between September and November 2017, an outbreak of urban pneumonic plague was declared in Madagascar, which refocused the attention of the scientific community on this ancient human scourge. Given recent trends and plague’s resilience to control in the wild, its high fatality rate in humans without early treatment, and its capacity to disrupt social and healthcare systems, human plague should be considered as a neglected threat. A workshop was held in Paris in July 2018 to review current knowledge about plague and to identify the scientific research priorities to eradicate plague as a human threat. It was concluded that an urgent commitment is needed to develop and fund a strong research agenda aiming to fill the current knowledge gaps structured around 4 main axes: (i) an improved understanding of the ecological interactions among the reservoir, vector, pathogen, and environment; (ii) human and societal responses; (iii) improved diagnostic tools and case management; and (iv) vaccine development. These axes should be cross-cutting, translational, and focused on delivering context-specific strategies. Results of this research should feed a global control and prevention strategy within a “One Health” approach.
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Xavier Vallès, Nils Stenseth, Christian Demeure, Peter Horby, Paul Mead, et al.. Human plague: An old scourge that needs new answers. PLoS Neglected Tropical Diseases, Public Library of Science, 2020, 14 (8), pp.e0008251. ⟨10.1371/journal.pntd.0008251⟩. ⟨pasteur-02928741⟩

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