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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Plague facts
• What is plague?
• What is the history of the plague?
• What causes plague?
• How is plague spread?
• What are plague symptoms and signs?
• How is plague diagnosed?
• What is the treatment for the plague? What is the prognosis of the plague?
• How can plague be prevented?
• Is there a vaccine against plague?
• What research is being done on plague?
• Where can more information be found on plague?
• Plague Index

There are vaccines against plague, but none are commercially available in the U.S. Most vaccines are made from heat-killed and chemically treated Y. pestis bacterial cells. The small amount of vaccine currently available is obtainable from the U.S. government and usually given to only a small number of individuals (for example, researchers working with Y. pestis). Currently, there is interest in further vaccine development and possible production because of potential bioterrorist use of this disease. Recent research indicates that a vaccine that stimulates the production of a pro-inflammatory cytokine (a chemical involved in the immune response) termed IL-17 results in a vaccine that better protects experimental animals from Y. pestis and may be helpful in producing a better vaccine in the future. Currently, a vaccine company, DynPort, is in clinical trials of a new plague vaccine for the U.S. Department of Defense; there is no FDA-approved vaccine against plague.

Research on the cause of plague, Y. pestis, has increased in recent years due to the threat of its use in potential bioterrorism attacks or as a weapon to subdue or decimate human populations. Genetic studies are under way to help design better vaccines with few side effects. Some Y. pestis strains have been found to have plasmid-generated antibiotic resistance so newer drugs are being tested, alone or in combination, to be ready to treat any outbreaks of these strains. Rapid diagnostic tests are being studied to quickly detect the organisms, especially under battlefield conditions. Such tests may allow better testing to undercover potential environmental (endemic) sites that could lead to outbreaks.

As mentioned in the history section, new research shows that Y. pestis has not changed significantly in hundreds of years. The researchers suggest their findings support the conclusion that factors other than microbial genetics, such as environment, vector dynamics, and host susceptibility, should be at the forefront of epidemiological discussions regarding emerging Y. pestis infections.