An Overview of the Plague Situation and Its Vectors in Iran

Abstract

Plague is an important and serious zoonotic disease caused by the bacterium Yersinia pestis. This study is a narrative review. The required data for the research were gathered through a search in search engines such as Google Scholar and international scientific databases, including PubMed, Web of Science, ScienceDirect, Scopus, Elsevier, and Lilacs, as well as Persian databases like the Barakat Knowledge Network System (Barakatkns), the Scientific Information Database (SID), the Iranian Medical Library (Medlib), and Civilica. The search was conducted using both Persian and English keywords, including "Plague," "Yersinia pestis," "Plague outbreak," "Flea," and "Control," through individual and combined searches over a period from 1974 to June 2024. In the present article, the agents and types of plague, its transmission methods, diagnostic approaches, the status of plague in the world and Iran, fleas in Iran, and methods for prevention and control of the disease will be discussed. This disease has caused three major historical pandemics, including the Black Death in the 14th century, which claimed millions of lives in Europe, Asia, and Africa and profoundly affected the populations of the impacted countries. Recently, the highest number of human plague cases has been reported from Madagascar. The main vector of the disease in humans is known as Xenopsylla cheopis worldwide. In Iran, records of human plague date back to the past. Climate change and ecological shifts may influence the distribution of plague vectors and hosts, increasing the risk of its resurgence even in areas where the disease is currently dormant. In Iran, increasing interactions between human communities and wildlife, along with changes in agricultural practices influenced by climatic factors, could facilitate the spread of the plague. Reports of the pathogen in rodents and dogs in western Iran (Kurdistan and Hamadan) underscore the significance of the potential re-emergence of plague in the region. There are three clinical forms of this disease bubonic, septicemic, and pulmonary. The most common type of plague is bubonic plague, which occurs following the bite of a flea that has previously fed on an infected animal. It presents with symptoms including fever, headache, chills, weakness, fatigue, and swollen, inflamed lymph nodes. Delayed treatment increases the risk of mortality associated with the disease. Plague, with a history of horror and devastation, remains a global health challenge. Understanding the current situation of this disease and reviewing its prevention and control is very important to prevent its re-emergence. Considering the current plague situation in Iran, there is a need for continuous monitoring and more detailed studies on the ecology of vectors, as well as the development of effective strategies for disease control and prevention. International cooperation in scientific research and exchanging information about plague outbreaks and control strategies are among the other effective approaches in this field. Finally, strengthening the health infrastructure and developing educational programs for the community is one of the most important requirements to prevent the spread of plague and other infectious diseases in Iran.

Keywords

• yersinia pestis
• prevention and control
• iran
• world