Escalating Health Crisis: Rising Cases of Lethal Plague
Rural communities worldwide are experiencing an uptick in infections related to two distinct pathogens: the plague, caused by the bacterium *Yersinia pestis*, and the Borna virus.
The plague, often associated with the Middle Ages, is making a comeback in rural areas due to several factors. Increased rodent populations, resulting from climate change, changes in land use, or poor waste management, provide a breeding ground for the oriental rat flea (*Xenopsylla cheopis*), which transmits the disease. Additionally, close contact with wild animals or livestock in rural settings increases the risk of exposure to these fleas. Limited access to healthcare and preventive measures in these areas can also delay diagnosis and treatment.
Protective measures against the plague include rodent control, the use of insect repellents, avoiding contact with dead animals, prompt diagnosis and treatment, and public health surveillance.
On the other hand, the Borna virus, primarily affecting horses and sheep, is not considered a type of plague and is not transmitted by fleas. Its occurrence in humans is extremely rare and is primarily associated with rural settings due to contact with these animals. If there is a perceived rise in Borna virus infections in rural areas, it is likely tied to increased animal contact and potentially better surveillance or diagnostic capabilities.
Preventive measures for Borna virus infections, if applicable, involve avoiding contact with infected animals, practicing good hand hygiene after handling livestock, and educating rural populations about potential zoonotic infections.
A summary of the main causes of rise in rural areas and protective measures for each disease is provided below:
| Disease/Agent | Main Causes of Rise in Rural Areas | Protective Measures | |--------------------|---------------------------------------------|-----------------------------------------------------------------| | Plague (Y. pestis) | Rodent population increase, close animal contact, weak health infrastructure | Rodent control, insect repellents, avoiding dead animals, early treatment[1] | | Borna virus | Animal contact (horses, sheep), improved surveillance | Avoid infected animals, good hygiene, public awareness |
Research is ongoing for early diagnosis of the Borna virus, with promising results from pilot trials using post-exposure prophylactics such as interferons. The virus, known as BoDV-1, has caused the deaths of two men in Pfaffenhofen, Germany, and has been circulating undetected in the animal kingdom, particularly in field mice.
Anyone active in the garden, barn, or stable in the coming months should take protective measures seriously, as the virus can be stirred up by autumn garden work. Experts recommend protective measures such as FFP2 masks, gloves, and avoiding dead small mammals. Field mice often live in hedges, cellars, and old barns, increasing the risk of exposure.
Health authorities are meticulously investigating the two deaths and have invited an information event due to the rise of the virus. Authorities are also planning digital risk maps and early warning systems for rural areas to combat the spread of both the plague and the Borna virus. So far, there have been no indications of asymptomatic spread in affected regions, but the risk remains underestimated, particularly for those living on the outskirts of rural communities.
[1] World Health Organization. (2021). Plague. Retrieved from https://www.who.int/news-room/fact-sheets/detail/plague
Other medical-conditions, like the Borna virus, are also becoming more prevalent in rural areas, primarily due to increased animal contact and potentially better diagnostic capabilities. Preventive measures for the Borna virus include avoiding contact with infected animals, practicing good hand hygiene after handling livestock, and educating rural populations about potential zoonotic infections. Additionally, health-and-wellness practices such as wearing FFP2 masks, gloves, and avoiding dead small mammals can help protect individuals active in gardens, barns, or stables from the virus.
