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Identifying Sources of Human Exposure to Plague

Jennifer L. Lowell,^1* David M. Wagner,³ Bakyt Atshabar,⁴ Michael F. Antolin,² Amy J. Vogler,³ Paul Keim,³ May C. Chu,^,1 and Kenneth L. Gage¹

Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention,¹ Department of Biology, Colorado State University, Fort Collins, Colorado,⁴ M. Aikimbayev's Kazakh Scientific Center for Quarantine and Zoonotic Diseases, Almaty, Kazakhstan,³ Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona²

Received 28 July 2004/ Returned for modification 30 September 2004/ Accepted 17 October 2004

Yersinia pestis, the etiologic agent of plague, has shaped the course of human history, killing millions of people in three major pandemics. This bacterium is still endemic in parts of Asia, Africa, and the Americas, where it poses a natural disease threat to human populations. Y. pestis has also recently received attention as a possible bioterrorism agent. Thus, rapid methods to distinguish between bioterrorism and naturally occurring plague infections are of major importance. Our study is the first to demonstrate that variable-number tandem repeats (VNTRs) in the Y. pestis genome can link human case isolates to those obtained from suspected environmental sources of infection. We demonstrate the valuable utility of VNTR markers in epidemiological investigations of naturally occurring plague and the forensic analysis of possible bioterrorism events.

Present address: World Health Organization, Dulles, VA 20189-5120.

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