Lessons Learned from Historic Plague Epidemics: The Relevance of an Ancient Disease in Modern Times

Plague has been without doubt one of the most important and devastating epidemic diseases of mankind. During the past decade, this disease has received much attention because of its potential use as an agent of biowarfare and bioterrorism. However, while it is easy to forget its importance in the 21st century and view the disease only as a historic curiosity, relegating it to the sidelines of infectious diseases, plague is clearly an important and re-emerging infectious disease. In today’s world, it is easy to focus on its potential use as a bioweapon, however, one must also consider that there is still much to learn about the pathogenicity and enzoonotic transmission cycles connected to the natural occurrence of this disease. Plague is still an important, naturally occurring disease as it was 1,000 years ago. This review highlights some of the important aspects of the disease throughout history with a discussion of the current situation of naturally occurring plague in the 21st century. of this infection is known to ultimately have resulted in epidemics and pandemics [4]. In most of the surveyed endemic regions worldwide, incl. the United States, specific rodent species have been identified that acquire the infection via flea bites; however, virtually all mammals are considered susceptible to become infected with Yersinia pestis, the causative agent of plague [5]. In most instances, humans become infected via flea bites and the rat flea, Xenopsylla cheopis, has been described as the classic vector for disease transmission. Additionally, other fleas such as Xensopsylla orientalis and Oropsylla montanus, have been shown to be effective vectors for the transmission of plague [5-7]. However, it is worth recognizing that the divide between domestic-rodent and wild-rodent plague has historically been an arbitrary line of division, considering that many rodents are now found living in the wild as well domestic and suburban environments. Humans become accidentally infected when handling infected animals or after being bitten by a flea that has previously fed on infected rodents [3-5]. At the time of writing this review, this infamous disease is internationally recognized as a re-emerging disease [6], its causative organism Y. pestis classified as a select agent in the United States, and recognized as a potential agent of biowarfare and bioterrorism [8-10]. Immediately after the attack on the U.S. World Trade Center in New York on September 11, 2001, much attention was given to plague as a disease related to biowarfare and bioterrorism; however, during the past 2 decades plague has silently re-emerged as a natural disease in many parts of the world and unrelated to human activities. Despite major advances in diagnosis, treatment, and prevention, it has not been possible to eradicate this disease. In this review, we will provide a summary of previous, historic plague pandemics, followed by a discussion of lessons that may have been learned from these events, as those could apply Citation: Boire NA, Riedel VAA, Parrish NM, Riedel S (2014) Lessons Learned from Historic Plague Epidemics: The Relevance of an Ancient Disease in Modern Times. J Anc Dis Prev Rem 2: 114. doi: 10.4172/2329-8731.1000114