Drancourt Michel, Houhamdi Linda, Raoult Didier
Unité des Rickettsies CNRS UMR 6020, IRF 48, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
Lancet Infect Dis. 2006 Apr;6(4):234-41. doi: 10.1016/S1473-3099(06)70438-8.
The classic epidemiological model of plague is an infection of rodents that is transmitted to human beings by rodent ectoparasites. This model fits with observations of sporadic and limited outbreaks, but hardly explains the persistence of plague foci for millennia or the epidemiological features drawn from the descriptions of historical pandemics. A comprehensive review of the published data, including scientific papers published in France between 1920 and 1940, allows the completion of the epidemiological chain by introducing soil as a reservoir, burrowing rodents as a first link, and human ectoparasites as the main driving force for pandemics. Modern studies are needed to confirm the validity of this controversial model and to assess the relative contribution of each link in the various epidemiological presentations of plague. If confirmed, these data should be taken into account to update public-health policies and bioterrorism risk management, particularly among ectoparasite-infested people.
鼠疫的经典流行病学模型是啮齿动物感染，通过啮齿动物体外寄生虫传播给人类。该模型符合散发性和有限疫情爆发的观察结果，但几乎无法解释鼠疫疫源地持续数千年的情况，也无法解释从历史大流行描述中得出的流行病学特征。对已发表数据进行全面回顾，包括1920年至1940年在法国发表的科学论文，通过引入土壤作为储存宿主、穴居啮齿动物作为第一环节以及人类体外寄生虫作为大流行的主要驱动力，完善了流行病学链条。需要进行现代研究以证实这一有争议模型的有效性，并评估各环节在鼠疫不同流行病学表现中的相对贡献。如果得到证实，这些数据应被考虑用于更新公共卫生政策和生物恐怖主义风险管理，尤其是在受体外寄生虫侵扰人群中。
