PLAGUE is a topic covered in the Harrison's Manual of Medicine.

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Yersinia pestis causes plague, a systemic zoonosis that primarily affects small rodents in rural areas of Africa (where 80% of all human cases worldwide occur), Asia, and the Americas. As the rodent population succumbs to disease, fleas (the arthropod vector) search for a new host and can transmit the bacteria to humans.

  • In addition to fleabites, direct contact with infected tissues or airborne droplets can cause human infections. Given the possibility of airborne transmission, Y. pestis is a potential agent of bioterrorism.
  • A mean of seven cases per year occur in the United States, most of them near the “Four Corners” (the junction point of New Mexico, Arizona, Colorado, and Utah) and further west in California, southern Oregon, and western Nevada.

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