文档介绍：CHAPTER
5544
Plague
Diane E. Williamson
DSTL Porton Down, Salisbury, Wiltshire, UK
OUTLINE
Introduction Indications for ination and target populations
Contraindications of ination
Short History of the Disease
Duration of immunity
Etiologic Agent Adverse events
Classification
Improved ines
Antigens Rationale for second-generation ines
Protective Immune Response Alternative ine Approaches: Rationally
Attenuated Mutants and DNA ines
Antibody
ines in Development
CMI
Discovery/Basic Science
Epidemiology
Preclinical development, including relevant animal models
Significance as Public Health Problem
Clinical Trials
Potential as Biothreat Agent Phase I
Phase II
Clinical Disease
Phase III
Diagnosis Postexposure immunoprophylaxis
Third-generation ines
Treatment
Prospects for the Future
Prophylactic ination
Key Issues
ines
History
Current ine
ines for Biodefense and Emerging and Neglected Diseases 1081 © 2009, Elsevier Inc.
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1082 PLAGUE
ABSTRACT
Killed whole cell ines for plague were first produced as long ago as the late 1890s and modified versions of
these are still used, with evidence that they are efficacious against bubonic plague. Renewed efforts with modern
technology have yielded new candidate ines that are less reactogenic, can be produced in a conventional
pharmaceutical manufacturing plant, and are protective against the life-threatening pneumonic form of the
disease. This chapter reviews the threat still posed by plague in the world today, the rationale for the research and
development of new ine formulations and assesses the likely impact of a prophylactic ine for pneumonic
plague.
INTRODUCTION plague (Perry and Fetherston, 1997). However, animal-
to-human or human-to-human transmission can occur
via droplet nuclei spread by the coughing