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Current Trends National Plague Conference Report

In response to the increased number of human plague cases in the western United States, an Ad Hoc National Plague Prevention and Control Committee held its first meeting February 22, and February 23, 1984, in Santa Fe, New Mexico. Sponsored by the New Mexico Health and Environment Department and CDC, the committee consisted of representatives from four state health departments, the Indian Health Service, CDC, Pan American Health Organization/World Health Organization, and one city health department. The agenda for the conference was: (1) develop standards for epidemiologic and environmental investigation of human plague cases in the United States; (2) assess and improve current surveillance and control strategies; and (3) establish short- and long-term research objectives aimed at preventing human plague cases.

The committee perceived a need to standardize investigation and reporting of all U.S. human plague cases. Subcommittees were appointed to develop surveillance forms for cooperative reporting of plague cases and field investigations by state and local health departments. Data submitted on these forms will be analyzed by CDC and used for ongoing plague research.

The committee concluded that current surveillance and control strategies appeared to be effective when systematically and intensively applied and that more effective and/or less costly surveillance and control strategies needed to be developed and defined.

The committee listed five priority areas for plague research directed toward preventing human plague cases and deaths. They are: (1) studies on the basic biology of flea vectors and plague ecology, with emphasis on interactions among vector, pathogen, and weather that may prolong survival of infective fleas and increase human transmission potential; (2) documentation of the role of pets in transporting or transmitting plague to humans; (3) studies to delineate plague risk factors among humans; (4) evaluation and improvement of existing plague control strategies directed at preventing human cases; and (5) development of improved and simplified laboratory diagnostic tests.

The committee recognized that human plague, despite its severe morbidity and moderate-to-high mortality, remains a disease of low, if increasing, incidence and that cost-benefit ratios of plague programs should be carefully considered. Although plague in nature is widespread throughout the western United States, definite geographic areas are identified as high-risk areas to humans. The committee views selective and increased commitment of both federal and state funds for research and the development of sound and cost-effective surveillance and control methods in recognized human high-risk areas as an important first step toward reducing human plague morbidity and mortality.

Copies of the committee report may be obtained from Allan M. Barnes, Ph.D., Plague Branch, Division of Vector-Borne Viral Diseases, Center for Infectious Diseases, CDC, P.O. Box 2087, Fort Collins, Colorado 80522. Reported by J Doll, PhD, Arizona Dept of Health Svcs; SB Werner, MD, B Nelson, PhD, California Dept of Health Svcs; J Emerson, DVM, Colorado Dept of Health; J Mann, MD, O Rollag, DVM, H Hull, MD, J Thompson, N Weber, New Mexico State Health and Environment Dept, T Brown, Environmental Improvement Div, C Montman, Albuquerque Environmental Health, G Heck, B Tempest, R Leach, R Grinnell, Indian Health Svc, New Mexico; J Rust, PhD, Pan American Health Organization/World Health Organization; Plague Br, Div of Vector-Borne Viral Diseases, Center for Infectious Diseases, CDC.

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