zoonoses and communicable diseases common to ... - PAHO/WHO

216 BACTERIOSESwhich is very effective and economical. If human plague cases occur, patients mustbe isolated (stringent isolation is required for pneumonic patients) and treated. Allcontacts should be disinfected and kept under surveillance; if deemed necessary,chemoprophylaxis (tetracycline and sulfonamides) should be given for six days; fleaand rodent control should be continued. In such places as the Andes, where fleainfestations on humans are prevalent, prophylactic measures are recommended forpersons attending funerals of plague victims, along with strict control of these casesto prevent human-to-human transmission.In the mountains of Tienshan (China), measures were taken to control the gray orAltai marmot (Marmota baibacina), a reservoir of plague. Between 1967 and 1987,the marmot population was reduced from 14.52 animals for every 10 hectares in1967 to 0.91 in 1987. More recently, bacteriologic and serologic tests were performedon 5,000 marmots and 2,000 domestic dogs; with the exception of threedogs, the tests were negative. No more human cases were reported (Lu et al., 1991).The inactivated vaccine provides protection for no more than six months and vaccinationis justified only for inhabitants of high-incidence areas, laboratory personnelwho work with plague, and people who must enter a plague focus. It should bekept in mind that several doses are needed to obtain a satisfactory level of protection.The inactivated vaccine was used on US troops in Vietnam and is believed tohave been very useful in protecting them.Plague is subject to control measures established under the International SanitaryCode (World Health Organization).BibliographyAkiev, A.K. Epidemiology and incidence of plague in the world, 1958–79. Bull WorldHealth Organ 60:165–169, 1982.Almeida, A.M.P. de., D.P. Brasil, F.G. de Carvalho, C.R. de Almeida. Isolamento daYersinia pestis nos focos pestosos do nordeste do Brasil no periodo de 1966 a 1982. Rev InstMed Trop Sao Paulo 27:207–218, 1985.Benenson, A.S., ed. Control of Communicable Diseases in Man. 15th ed. An official reportof the American Public Health Association. Washington, D.C.: American Public HealthAssociation; 1990.Bercovier, H., H.H. Mollaret, J.M. Alonso, J. Brault, G.R. Fanning, A.G. Steigerwalt, et al.Intra- and interspecies relatedness of Yersinia pestis by DNA hybridization and its relationshipto Yersinia pseudotuberculosis. Curr Microbiol 4:225–229, 1980.Butler, T. Plague. In: Warren, K.S., A.A.F. Mahmoud, eds. Tropical and GeographicalMedicine. New York: McGraw-Hill; 1984.Butler, T. The black death past and present. 1. Plague in the 1980s. Trans R Soc Trop MedHyg 83:458–460, 1989.Christie, A.B., T.H. Chen, S.S. Elberg. Plague in camels and goats: Their role in human epidemics.J Infect Dis 141:724–726, 1980.Davis, D.H.S., A.F. Hallett, M. Isaacson. Plague. In: Hubbert, W.T., W.F. McCulloch, P.R.Schnurrenberger, eds. Diseases Transmitted from Animals to Man. 6th ed. Springfield:Thomas; 1975.Dinger, J.E. Plague. In:Van der Hoeden, J., ed. Zoonoses. Amsterdam: Elsevier; 1964.Eidson, M., J.P. Thilsted, O.J. Rollag. Clinical, clinicopathologic, and pathologic featuresof plague in cats: 119 cases (1977–1988). J Am Vet Med Assoc 199:1191–1197, 1991.Hudson, B.W., M.I. Goldenberg, J.D. McCluskie, H.E. Larson, C.D. McGuire, A.M.