TY - CHAP M1 - Book, Section TI - Plague A1 - Kugeler, Kiersten J. A2 - Boulton, Matthew L. A2 - Wallace, Robert B. PY - 2022 T2 - Maxcy-Rosenau-Last Public Health & Preventive Medicine, 16e AB - Plague is a highly virulent zoonosis that has claimed hundreds of millions of lives over recorded history.1–3 The etiologic agent, Yersinia pestis, persists in complex enzootic cycles of rodents and fleas in discrete geographic foci in Asia, Africa, and the Americas. Humans are incidental hosts, most often infected by flea bites, but also by direct contact with infected animal tissues or inhalation of infectious respiratory droplets. The clinical syndrome varies with route of inoculation of the bacterium, resulting in three primary clinical forms, bubonic, septicemic, and pneumonic plague. Although most cases of plague are sporadic and effective therapy exists, periodic outbreaks can generate fear among the public, driven by misinformation. Plague remains a persistent public health concern due to its rapid clinical course, high mortality, and potential for epidemic spread. Y. pestis is currently classified as a Tier 1 select agent, subject to high-level regulation and oversight, due to both its past and potential use as a bioweapon.4 SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1182667527 ER -