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      High Throughput, Multiplexed Pathogen Detection Authenticates Plague Waves in Medieval Venice, Italy

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          Abstract

          Background

          Historical records suggest that multiple burial sites from the 14th–16 th centuries in Venice, Italy, were used during the Black Death and subsequent plague epidemics.

          Methodology/Principal Findings

          High throughput, multiplexed real-time PCR detected DNA of seven highly transmissible pathogens in 173 dental pulp specimens collected from 46 graves. Bartonella quintana DNA was identified in five (2.9%) samples, including three from the 16th century and two from the 15th century, and Yersinia pestis DNA was detected in three (1.7%) samples, including two from the 14th century and one from the 16th century. Partial glpD gene sequencing indicated that the detected Y. pestis was the Orientalis biotype.

          Conclusions

          These data document for the first time successive plague epidemics in the medieval European city where quarantine was first instituted in the 14th century.

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          Most cited references51

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          Yersinia pestis--etiologic agent of plague.

          Plague is a widespread zoonotic disease that is caused by Yersinia pestis and has had devastating effects on the human population throughout history. Disappearance of the disease is unlikely due to the wide range of mammalian hosts and their attendant fleas. The flea/rodent life cycle of Y. pestis, a gram-negative obligate pathogen, exposes it to very different environmental conditions and has resulted in some novel traits facilitating transmission and infection. Studies characterizing virulence determinants of Y. pestis have identified novel mechanisms for overcoming host defenses. Regulatory systems controlling the expression of some of these virulence factors have proven quite complex. These areas of research have provide new insights into the host-parasite relationship. This review will update our present understanding of the history, etiology, epidemiology, clinical aspects, and public health issues of plague.
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            The body louse as a vector of reemerging human diseases.

            The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.
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              The concept of quarantine in history: from plague to SARS

              The concept of ‘quarantine’ is embedded in health practices, attracting heightened interest during episodes of epidemics. The term is strictly related to plague and dates back to 1377, when the Rector of the seaport of Ragusa (then belonging to the Venetian Republic) officially issued a 30-day isolation period for ships, that became 40 days for land travellers. During the next 100 years similar laws were introduced in Italian and in French ports, and they gradually acquired other connotations with respect to their original implementation. Measures analogous to those employed against the plague have been adopted to fight against the disease termed the Great White Plague, i.e. tuberculosis, and in recent times various countries have set up official entities for the identification and control of infections. Even more recently (2003) the proposal of the constitution of a new European monitoring, regulatory and research institution has been made, since the already available system of surveillance has found an enormous challenge in the global emergency of the severe acute respiratory syndrome (SARS). In the absence of a targeted vaccine, general preventive interventions have to be relied upon, including high healthcare surveillance and public information. Quarantine has, therefore, had a rebound of celebrity and updated evidence strongly suggests that its basic concept is still fully valid.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                10 March 2011
                : 6
                : 3
                : e16735
                Affiliations
                [1 ]Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UMR CNRS 6236 IRD 198, IFR48, Faculté de Médecine, Université de la Méditerranée, Marseille, France
                [2 ]Anthropologie Bioculturelle, UMR 6578 CNRS, EFS, Université de la Méditerranée, Marseille, France
                [3 ]Soprintendenza Archeologica del Veneto, Venice, Italy
                University of Iowa, United States of America
                Author notes

                Conceived and designed the experiments: DR MD GA. Performed the experiments: TT LF MS. Analyzed the data: MS LF GA DR MD. Contributed reagents/materials/analysis tools: LF DR. Wrote the paper: TT MS MD GA.

                Article
                PONE-D-10-04467
                10.1371/journal.pone.0016735
                3053355
                21423736
                afef2c39-c04c-433d-bbb4-c58a9d7d66f0
                Tran et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 19 October 2010
                : 26 December 2010
                Page count
                Pages: 5
                Categories
                Research Article
                Medicine
                Infectious Diseases
                Bacterial Diseases
                Bubonic Plague
                Plagues
                Septicemic Plagues

                Uncategorized
                Uncategorized

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