Human plague: An old scourge that needs new answers.

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.

Factores de riesgo asociados a fasciolasis humana en tres provincias del departamento de Cajamarca, Perú / Risk factors related to human fasciolosis in three provinces from Cajamarca, Peru û 2010

Estudio Epidemiológico transversal retrospectivo. Objetivo: identificar factores de riesgo asociados a exposición a Fasciola hepatica en pobladores de las provincias de Cajabamba, San Marcos y Celendín, del departamento de Cajamarca - Perú. Metodología: Se utilizaron fichas clínico epidemiológicas del Estudio de prevalencia de fasciolosis en humanos en la Región Cajamarca desarrollado el año 2010. Las variables consideradas en el estudio fueron: lugar de procedencia, grupo poblacional (edad escolar o adulto), sexo, consumo de agua, consumo de vegetales crudos, signos clínicos y diagnóstico serológico actual. Resultados y Conclusiones: Se recabaron 341 fichas en total, de las cuales 34 correspondían a pacientes positivos a la prueba diagnóstica ELISA, correspondiendo a una prevalencia de infección por F. hepatica de 10%. La procedencia de los casos de las provincias San Marcos y Cajabamba (p=0,011) y el consumo de agua no tratada (p=0,026) resultaron ser factores de riesgo asociados a la fasciolosis. Además se encontró que en los individuos que presentaban disminución de peso, existía una mayor probabilidad de ser seropositivos a F. hepatica (p=0,002). Se espera que los resultados permitan contribuir con el conocimiento de la epidemiología de esta enfermedad y aporte información para la toma de decisión en futuras intervenciones en la región.

Aim:To identify risk factors linked to Fasciola hepatica exposure to the population of Cajabamba, San Marcos and Celendin provinces in Cajamarca - Peru. Methods: By using epidemiological clinical surveys of the project ôStudy of prevalence of fasciolosis in humans in the Cajamarca region developed in 2010. The variables considered in the study were: place of origin, population group (school age or adult), genre, water consumption, raw vegetables consumption, clinical symptoms and current serological diagnosis. Results and Conclusions: 341 clinical and epidemiological surveys were collected, of which 34 were positive for ELISA Cajamarca, corresponding to a prevalence of infection by F. hepatica of 10%. People who came from San Marcos and Cajabamba provinces (p = 0.011) and untreated water consumption (p = 0.026) were found to be risk factors linked to fasciolosis. In addition underweight individuals were at greater risk to be seropositive to F. hepatica (p = 0.002).We expect that the results of this study can contribute to the knowledge about this disease in the region and help to identify unsafe practices linked with fasciolosis.