Metapopulation dynamics of bubonic plague.

Bubonic plague is widely regarded as a disease of mainly historical importance; however, with increasing reports of incidence and the discovery of antibiotic-resistant strains of the plague bacterium Yersinia pestis, it is re-emerging as a significant health concerns. Here we bypass the conventional human-disease models, and propose that bubonic plague is driven by the dynamics of the disease in the rat population. Using a stochastic, spatial metapopulation model, we show that bubonic plague can persist in relatively small rodent populations from which occasional human epidemics arise, without the need for external imports. This explains why historically the plague persisted despite long disease-free periods, and how the disease re-occurred in cities with tight quarantine control. In a contemporary setting, we show that human vaccination cannot eradicate the plague, and that culling of rats may prevent or exacerbate human epidemics, depending on the timing of the cull. The existence of plague reservoirs in wild rodent populations has important public-health implications for the transmission to urban rats and the subsequent risk of human outbreaks.