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Case Reports
. 2024 Sep 4:12:1408025.
doi: 10.3389/fpubh.2024.1408025. eCollection 2024.

Status and analysis of undetected plague cases in Yunnan Province, China

Chao Su #  1   2 , Biao Duan #  2 , Qun Duan #  1 , Zhaokai He #  3 , Hanyu Sha #  1 , Yun Liang #  2 , Ennian Pu  2 , Shuai Qin  1 , Ran Duan  1 , Dongyue Lyu  1 , Wenbao Li  4 , Deming Tang  5 , Peng Zhang  6 , Meng Xiao  1 , Lianxu Xia  1 , Huaiqi Jing  1 , Xin Wang  1 , Zihou Gao  2 , Biao Kan  1
Affiliations
Case Reports

Status and analysis of undetected plague cases in Yunnan Province, China

Chao Su et al. Front Public Health. .

Abstract

Background: The virulence of Yersinia pestis strains in the Rattus flavipectus plague focus is relatively low. The purpose of this study was to investigate the undetected, sporadic plague cases in plague foci and provide the basis for plague prevention and control.

Methods: A 3-year-old plague-confirmed case was investigated in the R. flavipectus plague focus of Yunnan Province in 2020 due to the intensive screening for fever symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Epidemiological investigation, laboratory testing, and clinical treatment were conducted for the case. The expanded survey was carried out around the case within a 7-km radius, including the resident population, domesticated dogs, and rats. PCR and indirect hemagglutination tests were performed on the collected samples.

Results: The isolation rates of Y. pestis were 100.0% (7 out of 7) in dead rats and 4.00% (3 out of 75) in live rats in the survey area of the foci. A total of 5.00% (6 out of 120) of the domesticated dogs were F1 antibody positive. Nine local people were determined for plague infection recently (0.92%, 9 out of 978). The locations of human cases coincided with the Y. pestis epidemic area among the animals.

Conclusion: This study discovered the existence of plague cases that had not been detected by routine surveillance in the R. flavipectus plague focus, and the actual epidemic of human infection may be underestimated.

Keywords: IHA; Rattus flavipectus plague focus; Yersinia pestis; plague; undetected plague cases.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Historical and 2020 plague prevalences in Menghai County. (A) The number of Yersinia pestis strains isolated in Menghai County in 1992–2021. (B) A 7 km survey area around He’an Dazhai. (C) Green circles indicate that there were Y. pestis F1 antibody-positive cases at the sample sites (larger circles indicate more cases); red circles indicate that Y. pestis strains were isolated from rats at the sampling sites (larger circles indicate more strains); and blue circles indicate that no Y. pestis F1 antibody-positive cases or Y. pestis strains in rats were found at the sampling sites.
Figure 2
Figure 2
Investigation timeline of the patient.
See this image and copyright information in PMC

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