Plague and Other Yersinia Infections

Transcription

1 Plague and Other Yersinia Infections

2 CURRENT TOPICS IN INFECTIOUS DISEASE Series Editors: William B. Greenough III Division of Geographic Medicine The Johns Hopkins University. School of Medicine Baltimore, Maryland Thomas C. Merigan Head, Division of Infectious Disease Stanford University Medical Center Stanford, California The Atypical Mycobacteria and Human Mycobacteriosis John S. Chapman Infections of the Gastrointestinal Tract: Microbiology, Pathophysiology, and Clinical Features Herbert L. DuPont and Larry K. Pickering Coccidioidomycosis: A Text Edited by David A. Stevens Cytomegalovirus: Biology and Infection MontoHo Infective Endocarditis and Other Intravascular Infections Lawrence R. Freedman Plague and Other Yersinia Infections Thomas Butler A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

3 Plague and Other Yersinia Infections Thomas Butler International Center for Diarrhoeal Research Dhaka, Bangladesh Case Western Reserve University Cleveland, Ohio PLENUM MEDICAL BOOK COMPANY New York and London

4 Library of Congress Cataloging in Publication Data Butler, Thomas C., date- Plague and other Yersinia infections. (Current topics in infectious disease) Bibliography: p. Includes index. 1. Plague. 2. Yersinia infections. I. Title. II. Series. RC17I.B '23 ll ISBN ISBN (ebook) DOl / Plenum Press, New York Softcover reprint of the hardcover 1st edition Spring Street, New York, N.Y Plenum Medical Book Company is an imprint of Plenum Publishing Corporation All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

5 To Elisabeth, Pauline, Thomas, and Thomas

6 Preface 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 servicemen died of combat injuries. In the United States during these same years, the numbers of human cases of plague increased severalfold owing to wellentrenched 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 discovered in persons with diarrhea and acute abdominal pain simulating appendicitis. 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. Both forms of Yersinia infection have a predilection for lymph nodes and can disseminate via the bloodstream. The different vii

7 Preface species share certain antigens and toxins and both harbor plasmids which govern virulence. This monograph is intended for use by students, physicians, and public health workers who wish to gain a greater understanding of these diseases. The medical aspects have been stressed and an attempt made to provide balanced coverage of epidemiology, pathogenesis and clinical features, diagnosis and treatment, and control measures. The book does not try to review all recent findings on the yersiniae, because the explosion of knowledge in the past decades has created vast quantities of information. Other sources of information have been cited for the more interested readers. My own search for an understanding of Yersinia infections has taken me on a personal odyssey. After seeing patients with plague for the first time in Da Nang, Vietnam in 1969, I had opportunities to study and treat more plague victims in Da Nang and Saigon, to attend the International Symposium in Saigon in 1970, to view Yersin's notebook in Nha Trang in 1974, and to teach at the University of Saigon up to Visits to Vietnam were interspersed between stretches of laboratory and experimental work in Baltimore, Cleveland, and Stockholm. In 1978 and 1979 I made field trips to Garanhuns, Brazil. Finally, since 1981 I have been in Bangladesh to work on diarrheal diseases, incidentally finding Yersinia species in patients with diarrhea. Dhaka, Bangladesh THOMAS BUTLER viii

8 Contents Chapter 1. Introduction Chapter 2. Discovery of the Organisms Life of Alexandre Yersin ( ) Youth and Education Paris: Influence of Pasteur, Work with Roux on Diphtheria The Orient: Explorations in Indochina Discovery of the Plague Bacillus The Yersin-Kitasato Controversy Further Work on Plague Other Activities Final Years Nomenclature History of Yersinia enterocolitica and Yersinia pseudotuberculosis The. Life and Work of K. F. Meyer ( ) 26 References Chapter 3. Epidemiology Plague Cycles of Transmission World Distribution of Human Plague Plague in Vietnam Plague in Burma Plaguein BraziL ix

9 Contents Plague in the United States Plague in Indonesia Ecology of Plague Mortality from Plague Yersinia enterocolitica Infection Geographic Distribution Serotypes and Biotypes Reservoirs and Environmental Sources Epidemics Seasonal Variation in Occurrence Effects of Age and Sex Other Host Factors Relationship to Other Infections Yersinia pseudotuberculosis Infection References Chapter 4. Clinical Syndromes and Pathology in Humans Plague Bubonic Plague Cutaneous Manifestations Septicemic Plague Pneumonic Plague Meningeal Plague Plague Pharyngitis... < Liver and Spleen Involvement Kidney Involvement Cardiac Involvement Hematological Aspects Plague-Simulating Surgical Emergencies Differential Diagnosis Mortality Yersinia enterocolitica Infection..., Acute Enteritis Abdominal Pain and Appendicitislike Syndrome Arthritis Erythema Nodosum Septicemia and Generalized Infections x

10 Contents Miscellaneous Clinical Fonns Yersinia pseudotuberculosis Infection References Chapter 5. Pathogenesis and Toxins Plague... III Introduction Virulence Detenninants Detenninants of Pathogenicity Yersinia enterocolitica Infection Experimental Infections Invasive Properties of Yersinia enterocolitica Plasmid-Mediated Control of Invasiveness Enterotoxin Production by Yersinia enterocolitica Role of Serum Complement and Bacterial Endotoxin in Pathogenesis Temperature Dependence of Virulence of Yersinia enterocolitica Role of Iron in Pathogenesis Pathogenesis of Yersinia Arthritis Yersinia pseudotuberculosis Infection Experimental Infections Invasiveness for HeLa Cells Lipopolysaccharides of Yersinia pseudotuberculosis Other Virulence Detenninants of Yersinia pseudotuberculosis References Chapter 6. Diagnosis and Treatment The Diagnosis of Plague Clinical Diagnosis Bacteriological Diagnosis Electrophoresis of Yersinia pestis Serological Techniques xi

11 Contents 6.2. Diagnosis of Yersinia enterocolitica and Yersinia pseudotuberculosis Infections Clinical Diagnosis Bacteriological Diagnosis Serological Techniques Problems with Specificity of Yersinia Serology Treatment of Plague Antibiotics Supportive Therapy Treatment of Yersinia Infections Antibiotic Therapy Avoidance of Unnecessary Surgery References Chapter 7. Prevention and Control Control of Plague Sentinel Animals for Plague Surveillance Effectiveness of Strategies for Plague Control Plague Vaccine: A Brief History Use of Plague Vaccine in Vietnam Recommended Use of Vaccines Today Newer Approaches to Vaccination Can Plague Be Eradicated?... ' Control of Other Yersinia Infections References Index xii