Main description:

During the past decade, plague infections have persisted with undiminished importance in foci of the Americas, Africa, and Asia, while infections caused by the other yersiniae were recognized only during this decade as important agents of diarrheal and appendicitislike outbreaks in Europe, North America, and Japan. The dramatic rise of plague was abetted by the military conflict in Vietnam in the latter 1960s and persisted into the 1970s. During these years more Vietnamese people probably died of plague than American ser- vicemen died of combat injuries. In the United States during these same years, the numbers of human cases of plague increased severalfold owing to well- entrenched endemic foci in the sylvatic rodent species of the southwestern states. , In the latter 1960s, microbiologists had changed the name of the plague bacillus from Pasteurella pestis to Yersinia pestis. The other two pathogenic species, Yersinia enterocolitica and Yersinia pseudotuberculosis, were known causes of mesenteric lymphadenitis and were believed to be rare. However, there originated a strong interest in these diseases in the European countries of Sweden, Finland, Belgium, and France.
Yersiniae were frequently dis- covered in persons with diarrhea and acute abdominal pain simulating ap- pendicitis. This discovery sparked a worldwide surge of scientific interest in the genus Yersinia. Previous writings about the yersiniae have rarely considered plague and nonplague yersiniae together. Diseases caused by these bacteria, although their epidemiological patterns and clinical pictures are very different, have some striking similarities.

Contents:

1. Introduction.- 2. Discovery of the Organisms.- 2.1. Life of Alexandre Yersin (1863-1943).- 2.1.1. Youth and Education.- 2.1.2. Paris: Influence of Pasteur, Work with Roux on Diphtheria.- 2.1.3. The Orient: Explorations in Indochina.- 2.1.4. Discovery of the Plague Bacillus.- 2.1.5. The Yersin-Kitasato Controversy.- 2.1.6. Further Work on Plague.- 2.1.7. Other Activities.- 2.1.8. Final Years.- 2.2. Nomenclature.- 2.3. History of Yersinia enterocolitica and Yersinia pseudotuberculosis.- 2.4. The Life and Work of K. F. Meyer (1884-1974).- References.- 3. Epidemiology.- 3.1. Plague.- 3.1.1. Cycles of Transmission.- 3.1.2. World Distribution of Human Plague.- 3.1.3. Plague in Vietnam.- 3.1.4. Plague in Burma.- 3.1.5. Plague in Brazil.- 3.1.6. Plague in the United States.- 3.1.7. Plague in Indonesia.- 3.1.8. Ecology of Plague.- 3.1.9. Mortality from Plague.- 3.2. Yersinia enterocolitica Infection.- 3.2.1. Geographic Distribution.- 3.2.2. Serotypes and Biotypes.- 3.2.3. Reservoirs and Environmental Sources.- 3.2.4. Epidemics.- 3.2.5. Seasonal Variation in Occurrence.- 3.2.6. Effects of Age and Sex.- 3.2.7. Other Host Factors.- 3.2.8. Relationship to Other Infections.- 3.3. Yersinia pseudotuberculosis Infection.- References.- 4. Clinical Syndromes and Pathology in Humans.- 4.1. Plague.- 4.1.1. Bubonic Plague.- 4.1.2. Cutaneous Manifestations.- 4.1.3. Septicemic Plague.- 4.1.4. Pneumonic Plague.- 4.1.5. Meningeal Plague.- 4.1.6. Plague Pharyngitis.- 4.1.7. Liver and Spleen Involvement.- 4.1.8. Kidney Involvement.- 4.1.9. Cardiac Involvement.- 4.1.10. Hematological Aspects.- 4.1.11. Plague-Simulating Surgical Emergencies.- 4.1.12. Differential Diagnosis.- 4.1.13. Mortality.- 4.2. Yersinia enterocolitica Infection.- 4.2.1. Acute Enteritis.- 4.2.2. Abdominal Pain and Appendicitislike Syndrome.- 4.2.3. Arthritis.- 4.2.4. Erythema Nodosum.- 4.2.5. Septicemia and Generalized Infections.- 4.2.6. Miscellaneous Clinical Forms.- 4.3. Yersinia pseudotuberculosis Infection.- References.- 5. Pathogenesis and Toxins.- 5.1. Plague.- 5.1.1. Introduction.- 5.1.2. Virulence Determinants.- 5.1.3. Determinants of Pathogenicity.- 5.2. Yersinia enterocolitica Infection.- 5.2.1. Experimental Infections.- 5.2.2. Invasive Properties of Yersiniaenterocolitica.- 5.2.3. Plasmid-Mediated Control of Invasiveness.- 5.2.4. Enterotoxin Production by Yersiniaenterocolitica.- 5.2.5. Role of Serum Complement and Bacterial Endotoxin in Pathogenesis.- 5.2.6. Temperature Dependence of Virulence of Yersinia enterocolitica.- 5.2.7. Role of Iron in Pathogenesis.- 5.2.8. Pathogenesis of Yersinia Arthritis.- 5.3. Yersinia pseudotuberculosis Infection.- 5.3.1. Experimental Infections.- 5.3.2. Invasiveness for HeLa Cells.- 5.3.3. Lipopolysaccharides of Yersinia pseudotuberculosis.- 5.3.4. Other Virulence Determinants of Yersinia pseudotuberculosis.- References.- 6. Diagnosis and Treatment.- 6.1. The Diagnosis of Plague.- 6.1.1. Clinical Diagnosis.- 6.1.2. Bacteriological Diagnosis.- 6.1.3. Electrophoresis of Yersinia pestis.- 6.1.4. Serological Techniques.- 6.2. Diagnosis of Yersinia enterocolitica and Yersinia pseudotuberculosis Infections.- 6.2.1. Clinical Diagnosis.- 6.2.2. Bacteriological Diagnosis.- 6.2.3. Serological Techniques.- 6.2.4. Problems with Specificity of Yersinia Serology.- 6.3. Treatment of Plague.- 6.3.1. Antibiotics.- 6.3.2. Supportive Therapy.- 6.4. Treatment of Yersinia Infections.- 6.4.1. Antibiotic Therapy.- 6.4.2. Avoidance of Unnecessary Surgery.- References.- 7. Prevention and Control.- 7.1. Control of Plague.- 7.1.1. Sentinel Animals for Plague Surveillance.- 7.1.2. Effectiveness of Strategies for Plague Control.- 7.1.3. Plague Vaccine: A Brief History.- 7.1.4. Use of Plague Vaccine in Vietnam.- 7.1.5. Recommended Use of Vaccines Today.- 7.1.6. Newer Approaches to Vaccination.- 7.1.7. Can Plague Be Eradicated?.- 7.2. Control of Other Yersinia Infections.- References.