Early-phase transmission (EPT) of Yersinia pestis by unblocked fleas is a welldocumented, replicable phenomenon with poorly defined mechanisms. We review evidence demonstrating EPT and current knowledge on its biological and biomechanical processes. We discuss the importance of EPT in the epizootic spread of Y. pestis and its role in the maintenance of plague bacteria in nature.We further address the role of EPT in the epidemiology of plague.
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Vol. 52 • No. 6