Historical and genomic data reveal the influencing factors on global transmission velocity of plague during the Third Pandemic.

Quantitative knowledge about which natural and anthropogenic factors influence the global spread of plague remains sparse. We estimated the worldwide spreading velocity of plague during the Third Pandemic, using more than 200 years of extensive human plague case records and genomic data, and analyzed the association of spatiotemporal environmental factors with spreading velocity. Here, we show that two lineages, 2.MED and 1.ORI3, spread significantly faster than others, possibly reflecting differences among strains in transmission mechanisms and virulence. Plague spread fastest in regions with low population density and high proportion of pasture- or forestland, findings that should be taken into account for effective plague monitoring and control. Temperature exhibited a nonlinear, U-shaped association with spread speed, with a minimum around 20 °C, while precipitation showed a positive association. Our results suggest that global warming may accelerate plague spread in warm, tropical regions and that the projected increased precipitation in the Northern Hemisphere may increase plague spread in relevant regions.

Identification of Chinese plague foci from long-term epidemiological data.

Carrying out statistical analysis over an extensive dataset of human plague reports in Chinese villages from 1772 to 1964, we identified plague endemic territories in China (i.e., plague foci). Analyses rely on (i) a clustering method that groups time series based on their time-frequency resemblances and (ii) an ecological niche model that helps identify plague suitable territories characterized by value ranges for a set of predefined environmental variables. Results from both statistical tools indicate the existence of two disconnected plague territories corresponding to Northern and Southern China. Altogether, at least four well defined independent foci are identified. Their contours compare favorably with field observations. Potential and limitations of inferring plague foci and dynamics using epidemiological data is discussed.

Plague and climate: scales matter.

Plague is enzootic in wildlife populations of small mammals in central and eastern Asia, Africa, South and North America, and has been recognized recently as a reemerging threat to humans. Its causative agent Yersinia pestis relies on wild rodent hosts and flea vectors for its maintenance in nature. Climate influences all three components (i.e., bacteria, vectors, and hosts) of the plague system and is a likely factor to explain some of plague's variability from small and regional to large scales. Here, we review effects of climate variables on plague hosts and vectors from individual or population scales to studies on the whole plague system at a large scale. Upscaled versions of small-scale processes are often invoked to explain plague variability in time and space at larger scales, presumably because similar scale-independent mechanisms underlie these relationships. This linearity assumption is discussed in the light of recent research that suggests some of its limitations.

Human seroreactivity against Bartonella species in the Democratic Republic of Congo.

OBJECTIVE: To assess the presence and identity of Bartonella species in a pool of human blood samples from DRC Congo. METHODS: Blood (±120µL) was collected anonymously from Congolese patients and placed on calibrated filter papers. Bartonella serology determination was performed using an indirect immunofluorescence assay (IFA) against six specific Bartonella antigens and Coxiella burnetii (C. burnetii) antigen. The end cut-off value for Bartonella sp. was a titre greater than 1:200. RESULTS: None of the patients was positive for Bartonella elizabethae, Bartonella vinsonii subsp. vinsonii or Bartonella vinsonii subsp. arupensis nor for C. burnetti, but 4.5% of the 155 samples were positive for either Bartonella henselae, Bartonella quintana, or Bartonella clarridgeiae. CONCLUSIONS: This preliminary study presents the first report of Bartonella species in the DR Congo and the first report of antibodies to Bartonella clarridgeiae in an African human population. Although few experimental trials have established the link between fleas and Bartonella transmission, the repeated detection of similar Bartonella species in fleas and humans in several countries suggests that Bartonellosis could be another flea-borne disease which specific reservoirs are still unknown.

Influence of satellite-derived rainfall patterns on plague occurrence in northeast Tanzania.

BACKGROUND: In the tropics, rainfall data are seldom accurately recorded, and are often discontinuous in time. In the scope of plague-research in northeast Tanzania, we adapted previous research to reconstruct rainfall patterns at a suitable resolution (1 km), based on time series of NDVI: more accurate satellite imagery was used, in the form of MODIS NDVI, and rainfall data were collected from the TRMM sensors instead of in situ data. First, we established a significant relationship between monthly rainfall and monthly composited MODIS NDVI. The established linear relationship was then used to reconstruct historic precipitation patterns over a mountainous area in northeastern Tanzania. RESULTS: We validated the resulting precipitation estimates with in situ rainfall time series of three meteorological stations located in the study area. Taking the region's topography into account, a correlation coefficient of 0.66 was obtained for two of the three meteorological stations. Our results suggest that the adapted strategy can be applied fruitfully to estimate rainfall variability and seasonality, despite the underestimation of overall rainfall rates. Based on this model, rainfall in previous years (1986) is modelled to obtain a dataset with which we can compare plague occurrence in the area. A positive correlation of 82% is obtained between high rainfall rates and plague incidence with a two month lag between rainfall and plague cases. CONCLUSIONS: We conclude that the obtained results are satisfactory in support of the human plague research in which this study is embedded, and that this approach can be applied in other studies with similar goals.

Predicting potential risk areas of human plague for the Western Usambara Mountains, Lushoto District, Tanzania.

A natural focus of plague exists in the Western Usambara Mountains of Tanzania. Despite intense research, questions remain as to why and how plague emerges repeatedly in the same suite of villages. We used human plague incidence data for 1986-2003 in an ecological-niche modeling framework to explore the geographic distribution and ecology of human plague. Our analyses indicate that plague occurrence is related directly to landscape-scale environmental features, yielding a predictive understanding of one set of environmental factors affecting plague transmission in East Africa. Although many environmental variables contribute significantly to these models, the most important are elevation and Enhanced Vegetation Index derivatives. Projections of these models across broader regions predict only 15.5% (under a majority-rule threshold) or 31,997 km(2) of East Africa as suitable for plague transmission, but they successfully anticipate most known foci in the region, making possible the development of a risk map of plague.

Human plague occurrences in Africa: an overview from 1877 to 2008.

Plague remains a public health concern worldwide, but particularly in Africa. Despite the long-standing history of human plague, it is difficult to get a historical and recent overview of the general situation. We searched and screened available information sources on human plague occurrences in African countries and compiled information on when, where and how many cases occurred in a centralised database. We found records that plague was probably already present before the third pandemic and that hundreds of thousands of human infections have been reported in 26 countries since 1877. In the first 30 years of the 20th century, the number of human cases steadily increased to reach a maximum in 1929. From then on the number decreased and fell below 250 after 1945. Since the 1980s, again increasingly more human infections have been reported with the vast majority of cases notified in East Africa and Madagascar. We show that public health concerns regarding the current plague situation are justified and that the disease should not be neglected, despite the sometimes questionability of the numbers of cases. We conclude that improving plague surveillance strategies is absolutely necessary to obtain a clear picture of the plague situation in endemic regions.

Geographic distribution and ecological niche of plague in sub-Saharan Africa.

BACKGROUND: Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970-2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. RESULTS: We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. CONCLUSION: We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.

Plague and the human flea, Tanzania.

Domestic fleas were collected in 12 villages in the western Usambara Mountains in Tanzania. Of these, 7 are considered villages with high plague frequency, where human plague was recorded during at least 6 of the 17 plague seasons between 1986 and 2004. In the remaining 5 villages with low plague frequency, plague was either rare or unrecorded. Pulex irritans, known as the human flea, was the predominant flea species (72.4%) in houses. The density of P. irritans, but not of other domestic fleas, was significantly higher in villages with a higher plague frequency or incidence. Moreover, the P. irritans index was strongly positively correlated with plague frequency and with the logarithmically transformed plague incidence. These observations suggest that in Lushoto District human fleas may play a role in plague epidemiology. These findings are of immediate public health relevance because they provide an indicator that can be surveyed to assess the risk for plague.