Correlates of Immunity Elicited by Live Yersinia pestis Vaccine

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49.1 Introduction

Yersinia pestis is the causative agent of plague, one of the most severe bacterial infections in the history of mankind. Y. pestis has been squarely placed on the category A select agent list because of its potential to be used as an agent of biowarfare and bioterrorism (1). Most human plague cases usually present as one of three primary forms, i.e., bubonic, septicemic, or pneumonic, with the latter two having a high mortality rate (2). Currently, no plague vaccine exists in the United States, although until 1999, a formaldehyde-killed, whole-cell vaccine was available for military and laboratory personnel. This vaccine required a course of injections over a period of six months and was effective against bubonic plague. However, the protection was short-term and annual boosters were required; additionally, the incidence of side effects, such as malaise, headaches, elevated temperature, and lymphadenopathy, was high (in ̃10% of those immunized with vac ...