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About the Authors:
Rebecca J. Eisen
* E-mail: [email protected]
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
Jeff N. Borchert
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
Joseph T. Mpanga
Affiliation: Uganda Virus Research Institute, Entebbe, Uganda
Linda A. Atiku
Affiliation: Uganda Virus Research Institute, Entebbe, Uganda
Katherine MacMillan
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
Karen A. Boegler
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
John A. Montenieri
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
Andrew Monaghan
Affiliation: National Center for Atmospheric Research, Boulder, Colorado, United States of America
Kenneth L. Gage
Affiliation: Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
Introduction
Plague is a flea-borne rodent-associated zoonotic disease that is caused by Yersinia pestis and characterized by long quiescent periods punctuated by rapidly spreading epidemics and epizootics. Yersinia pestis is notorious for causing three major human pandemics that killed millions. The magnitude of these pandemics has been credited for changing economic and political history and for notable improvements in public health [1], [2]. In modern times, advances in diagnostics coupled with access to appropriate antibiotic therapy have resulted in a reduction in plague-related mortality rates; improved sanitation has limited the scale of epidemics to focal outbreaks [3]. Nonetheless, plague remains a standard against which modern scourges are compared and the recrudescence of plague can cause major disruptions to social and economic infrastructure at local scales that can have global ripple effects [4]. Defining the geographic foci in which Y. pestis persists during inter-epizootic periods and understanding the mechanisms of persistence are critical for designing interventions aimed at locally eliminating the pathogen and for anticipating where future epizootics are most likely to occur.
Plague foci represent areas where Y. pestis has persisted over long durations of time spanning multiple epidemics or epizootics that are often disrupted by periods of low and often undetectable transmission....