{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:43:48Z","timestamp":1792827828512,"version":"4.5.0"},"reference-count":23,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>From 2010 through 2019, the six leading countries by numbers of human plague cases reported to the WHO were, in order from highest to lowest, Madagascar, Congo, Uganda, Peru, Tanzania, and the United States. From these countries, there was a total of 4,547 cases, of whom 786 (17%) died. Top plague events were four outbreaks of primary pneumonic plague in Madagascar that affected 1,936 persons, including index cases, of whom 137 died. One of the outbreaks was caused by a streptomycin-resistant strain of <jats:italic>Yersinia pestis<\/jats:italic>. Person-to-person transmission occurred in a taxi, in households with family caregivers, at burial ceremonies and wakes for victims, and at a hospital where cases were treated. Unique clinical presentations in the United States included a dog owner who acquired pneumonic plague from his sick dog, a boy with septicemic plague who developed complications of osteomyelitis and arthritis that required surgery for bone removal and bone grafting, and a prairie dog handler who acquired bubonic plague from a bite by a sick prairie dog. Efficacy of antibiotics in a model of pneumonic plague in African green monkeys for use in bioterrorism revealed the most effective drugs to be gentamicin, ciprofloxacin, and levofloxacin. A recombinant vaccine containing Fraction 1 antigen and V antigen of <jats:italic>Y. pestis<\/jats:italic> designed for first responders during a bioterrorism attack and military personnel was tested for safety and immunogenicity but was not licensed for use by the end of the decade.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0331","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T11:38:20Z","timestamp":1695641900000},"page":"985-988","source":"Crossref","is-referenced-by-count":8,"title":["Plague Gives Surprises in the Second Decade of the Twenty-First Century"],"prefix":"10.4269","volume":"109","author":[{"given":"Thomas","family":"Butler","sequence":"first","affiliation":[{"name":"Ross University School of Medicine, Bridgetown, Barbados, West Indies, Retired"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0008251","article-title":"Human plague: an old 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August\u2013November, 2017: an outbreak report","volume":"19","author":"Randremanana","year":"2019"},{"key":"b7","series-title":"Emerg Infect Dis","first-page":"8","article-title":"Pneumonic plague outbreak, northern Madagascar, 2011","volume":"21","author":"Richard","year":"2015"},{"key":"b8","series-title":"Emerg Infect Dis","first-page":"521","article-title":"Pneumonic plague transmission, Moramanga, Madagascar, 2015","volume":"23","author":"Ramasindrazana","year":"2017"},{"key":"b9","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"429","article-title":"Outbreak of human pneumonic plague with dog-to-human and possible human-to-human transmission \u2013 Colorado, June\u2013July 2014","volume":"64","author":"Runfola","year":"2015"},{"key":"b10","series-title":"J Am Vet Med Assoc","first-page":"1176","article-title":"Yersinia pestis infection in dogs: 62 cases (2003\u20132011)","volume":"244","author":"Nichols","year":"2014"},{"key":"b11","series-title":"J Pediatric Infect Dis 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pneumonic plague outbreak","volume":"74","author":"Andrianaivoarimanana","year":"2022"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"S51","article-title":"The African green monkey model of pneumonic plague and US Food and Drug Administration approval under the animal rule","volume":"70","author":"Hewitt","year":"2020"},{"key":"b17","series-title":"Int J Toxicol","first-page":"327","article-title":"Preclinical safety assessment of a recombinant plague vaccine (rF1V)","volume":"32","author":"Price","year":"2013"},{"key":"b18","series-title":"Clin Vaccine Immunol","first-page":"1070","article-title":"Characterization of a cynomolgus macaque model of pneumonic plague for evaluation of vaccine efficacy","volume":"22","author":"Fellows","year":"2015"},{"key":"b19","series-title":"Hum Vaccin Immunother","first-page":"2334","article-title":"Immunogenicity and safety of a subunit plague vaccine: a randomized phase 2a clinical trial","volume":"12","author":"Chu","year":"2016"},{"key":"b20","series-title":"Clin Infect Dis","first-page":"893","article-title":"Cases of cat-associated human plague in the western US, 1977\u20131998","volume":"30","author":"Gage","year":"2000"},{"key":"b21","series-title":"Clin Infect Dis","first-page":"185","article-title":"A dog-associated case of primary pneumonic plague in Qinhai Province, China","volume":"52","author":"Wang","year":"2011"},{"key":"b22","series-title":"Antimicrob Agents Chemother","first-page":"1919","article-title":"In vitro antibiotic susceptibilities of Yersinia pestis determined by broth microdilution following CLSI methods","volume":"59","author":"Heine","year":"2015"},{"key":"b23","series-title":"Clin Infect Dis","first-page":"S20","article-title":"Antimicrobial treatment patterns and illness outcome among United States patients with plague, 1942\u20132018","volume":"70","author":"Kugeler","year":"2020"}],"container-title":["The American Journal of 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