The Gram-negative bacterium Yersinia pestis is responsible for deadly plague, a zoonotic disease established in stable foci in the Americas, Africa, and Eurasia. Its persistence in the environment relies on the subtle balance between Y. pestis-contaminated soils, burrowing and nonburrowing mammals exhibiting variable degrees of plague susceptibility, and their associated fleas. Transmission from one host to another relies mainly on infected flea bites, inducing typical painful, enlarged lymph nodes referred to as buboes, followed by septicemic dissemination of the pathogen. In contrast, droplet inhalation after close contact with infected mammals induces primary pneumonic plague. Finally, the rarely reported consumption of contaminated raw meat causes pharyngeal and gastrointestinal plague. Point-of-care diagnosis, early antibiotic treatment, and confinement measures contribute to outbreak control despite residual mortality. Mandatory primary prevention relies on the active surveillance of established plague foci and ectoparasite control. Plague is acknowledged to have infected human populations for at least 5,000 years in Eurasia. Y. pestis genomes recovered from affected archaeological sites have suggested clonal evolution from a common ancestor shared with the closely related enteric pathogen Yersinia pseudotuberculosis and have indicated that ymt gene acquisition during the Bronze Age conferred Y. pestis with ectoparasite transmissibility while maintaining its enteric transmissibility. Three historic pandemics, starting in 541 AD and continuing until today, have been described. At present, the third pandemic has become largely quiescent, with hundreds of human cases being reported mainly in a few impoverished African countries, where zoonotic plague is mostly transmitted to people by rodent-associated flea bites.

中文翻译：

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鼠疫耶尔森氏菌：鼠疫的自然史

革兰氏阴性菌鼠疫耶尔森菌是致命鼠疫的罪魁祸首，这是一种在美洲、非洲和欧亚大陆稳定疫源地建立的人畜共患疾病。它在环境中的持久存在依赖于鼠疫耶尔森氏菌污染的土壤、表现出不同程度鼠疫易感性的穴居和非穴居哺乳动物及其相关跳蚤之间的微妙平衡。从一个宿主到另一个宿主的传播主要依靠受感染的跳蚤叮咬，引起典型的疼痛、肿大的淋巴结（称为腹股沟淋巴结炎），然后引起病原体的败血症传播。相反，与受感染的哺乳动物密切接触后吸入飞沫会诱发原发性肺鼠疫。最后，很少有报道称食用受污染的生肉会导致咽部和胃肠道鼠疫。尽管存在残余死亡率，但护理点诊断、早期抗生素治疗和限制措施仍有助于控制疫情。强制性一级预防依赖于对已确定的鼠疫疫源地的主动监测和体外寄生虫控制。据了解，鼠疫在欧亚大陆感染人类至少 5000 年。从受影响的考古遗址恢复的鼠疫耶尔森氏菌基因组表明，鼠疫耶尔森氏菌来自与密切相关的肠道病原体假结核耶尔森氏菌共享的共同祖先的克隆进化，并表明青铜时代的ymt基因获得赋予鼠疫耶尔森氏菌外寄生虫传播性，同时保持其肠道传播性。描述了从公元 541 年开始一直持续到今天的三次历史性大流行。目前，第三次大流行已基本处于静止状态，报告了数百起人间病例，主要发生在一些贫困的非洲国家，这些国家的人畜共患鼠疫主要通过与啮齿动物相关的跳蚤叮咬传播给人们。