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International Medical Scientific Journal       Issue-1 

10.5281/zenodo.6034654 

18 

  



Art of Medicine           Volume-2 

International Medical Scientific Journal       Issue-1 

10.5281/zenodo.6034654 

19 

 

 
 

 

 

Art of Medicine International Medical Scientific journal 

 

Founder and Publisher Pascual Izquierdo-Egea 

Published science May 2021 year. Issued Quarterly. 

Internet address: http://artofmedicineimsj.us 

E-mail: info@artofmedicineimsj.us 

11931 Barlow Pl Philadelphia, PA 19116, USA +1 (929) 266-0862  

 

 
  



Art of Medicine           Volume-2 

International Medical Scientific Journal       Issue-1 

10.5281/zenodo.6034654 

20 

Features of the episodic process in the territory of natural focuses of the plague 

of the cis countries 

 

Dmitriev A.N.
1
, Nematov A.S.

2
, Rakhmanova D.A.

2
 

1
Uchkuduk anti-plague station" SI "NMMC Foundation", Uchkuduk, Republic of 

Uzbekistan,  
2 
Tashkent Institute of Postgraduate medical education."" Tashkent Medical 

Academy” of the Ministry of Health of the Republic of Uzbekistan, Tashkent, 

Republic of Uzbekistan  

 

Abstract: aEpizootological manifestations of the plague in 2011-2020 were 

registered on the territory of 11 states. Data on the Central Part of the Kyzylkum 

natural desert plague outbreak indicate a reduction in major and minor plague 

carriers. In the conditions of mountainous and high-altitude landscapes, the impact of 

modern climate warming on the state of parasitic systems of the mountain and high-

altitude natural plague foci is less pronounced. The epizootic potential of many 

autonomous biological principles of the gopher and sandy type has significantly 

decreased in the current century. 

Keywords: epizootic activity, natural plague focus, Central Kyzylkum, giant gerbil, 

Y. pestis. 
    

   In 2011-2020, the total number of plague cases was 6743, of which 906 

(13.4%) were fatal. A high incidence of the population was observed in Africa: in the 

Republic of Madagascar (5451), the Democratic Republic of the Congo (608), the 

Republic of Uganda (74) and the United Republic of Tanzania (61). In South and 

North America, cases of infection have been reported in the Republic of Peru (67), 

Bolivia (4), and the USA (51). Sporadic morbidity was recorded in Asia in the 

People's Republic of China (14), Mongolia (16), the Russian Federation (3), and the 

Kyrgyz Republic (1). The most difficult epidemiological situation in 2011-2020 was 

on the territory of the Republic of Madagascar, where a significant outbreak of 

pneumonic plague took place in 2017. In 2020, 535 cases were registered in four 

countries of the world (148 patients in six countries in 2019), of which 37 were fatal. 

Epidemiological problems were noted in the territories of the Democratic Republic of 

the Congo (520 cases; 31 deaths), the People's Republic of China (4 cases; 2 deaths), 

Mongolia (6 cases; 3 fatal), and the USA (5 cases of the disease; 1 terminal). In total, 

epizootological manifestations of the plague in 2011-2020 were registered on the 

territory of 11 states; 

  On the territory of the Russian Federation and other CIS countries, the 

presence of 45 natural plague foci of various biocenosis structures has been 

confirmed to date, the functioning of which is associated with the circulation of 

Yersiniapestispestis strains of medieval and ancient biovars, Caucasian and Central 

Asian subspecies. The total area of the plague-enzootic territory of the CIS countries 



Art of Medicine           Volume-2 

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is 2101288 km2. The total area of the historical range of Y. pestis strains of the 

medieval biovar 2.MED1 is 1959965 km2 - 93.3% of the entire enzootic plague 

territory of the CIS countries. Epizootic manifestations were registered on an area of 

352731 km2 (18.0%), the epidemic – on a site of 47241 km2 (2.4%). 

  Within the boundaries of the historical range of Y. pestispestis of the 

phylogenetic branch 2.MED1, 33 autonomous natural foci are currently located on 

the territory of the Caspian and Turanian lowlands, as well as the Caucasus and 

Transcaucasia, including sandy (25), gopher (6), marmot (2) types. The natural foci 

of the gopher type with the circulation of Y. pestispestis strains of the medieval 

bioware2.MED1 is 221347 km2; gerbil type - 1728676 km2; marmot type - 18442 

km2. 

The pulsations of epizootic activity observed in the XX century of individual 

autonomous natural foci of Y. pestispestis of the medieval biovar 2. climatic and 

anthropogenic factors entirely determined MED1. It should be assumed that it was 

the high ecological plasticity of Y. pestispestis strains of the medieval biovar 

2.MED1 decided the possibility of their distribution in populations of a broad species 

spectrum of rodents living in the territories of the Caspian and Turanian lowlands. 

  In the current century, due to the influence of modern climate warming, the 

epizootic potential of many autonomous natural foci of the gopher and sandy type 

with the circulation of Y. pestispestis strains of the medieval biovar has significantly 

decreased. In 2011-2020 years in the Russian Federation, songs of this branch were 

isolated only in 2013-2015 years on the territory of the Caspian gerbil natural hearth. 

On the Republic of Kazakhstan territory at the beginning of this century in the desert, 

autonomous natural foci with the circulation of Y. pestispestis of the medieval biovar, 

the last finds of infected animals took place in the Volga-Ural interfluve. Until now, 

in the Northern subzone of the desert zone of the Republic of Kazakhstan, only the 

North-Aral and Aral-Karakum desert natural foci have retained epizootic activity. In 

the Central part of the desert zone of Kazakhstan, the last manifestations of epizootic 

activity also took place on the territory of the Betpakdalinsky desert hearth – in 2014. 

A sharp decrease in epizootic activity occurred on the territory of the Republic of 

Turkmenistan (Kopetdag desert hearth – since 1969, Kara-Kum desert hearth – since 

2005) and the Republic of Uzbekistan (the southern part of the Kyzylkum desert 

hearth – since 2012). In the southern and southeastern regions of the Republic of 

Kazakhstan, high epizootic activity was recorded only in the Balkhash, Moynkum, 

Taukum desert, and Ili intermountain natural foci of Y. pestispestis of the medieval 

Bioware. In the western part of the Pamir-Alai mountain system, within the 

boundaries of the Hissar natural focus of the vole type with an area of 400 km2 (0.2% 

of the total area of the plague-enzootic territory of the CIS countries), the circulation 

of Y. pestis strains of the Hissar biovar of the Central Asian subspecies 0.PE4h was 

registered. The last findings of infected animals were recorded here in 1991. 

 In the last decade, the activation of the epizootic process in mountainous and 

high-altitude natural foci of Y. pestispestis of the ancient biovar of phylogenetic 

branches 0.ANT5 (Kyrgyz Republic), 4. ANT (Russian Federation) has been noted. 

On the territory of the Russian Federation in 2011-2020 years in the Tuva Mountain 



Art of Medicine           Volume-2 

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and Gorno-Altai high-mountain natural foci with the circulation of Y. pestispestis 

strains of the ancient biovar of the phylogenetic branch 4. ANT, the preservation of a 

tense epizootic and epidemiological situation was noted. In 2020 on the territory of 

the Russian Federation, local plague epizootics have been registered on the Altai 

Republic, as well as the Republic of Tyva. Plague epizootics were detected on the 

territory of two (Gorno-Altaisk highland and Tuva mountain) of 11 natural plague 

foci of the Russian Federation. In the course of further expansion of the range of Y. 

pestispestis of the ancient biovar of the phylogenetic branch 4. ANT in the western 

direction, it is impossible to exclude the possibility of forming a new cross-border 

focal territory within the boundaries of the Southern Altai ridge, located at the 

junction of the borders of four states - Russia, Mongolia, China, and Kazakhstan. 

 In the conditions of climate warming in the current decade, it is expected to 

maintain a multidirectional trend in the dynamics of epizootic activity of natural foci 

with the circulation of Y. pestispestis strains of the medieval biovar of the 

phylogenetic branch 2. MED1 and the ancient biovar of the phylogenetic branches 

0.ANT5, 4. ANT. On the territory of the Russian Federation, the parasitic systems of 

lowland natural foci of gopher and sandy-type plague with the spread of Y. 

pestispestis of the medieval biovar branch 2.MED1 will continue to remain in a state 

of deep depression. An increase in the temperature of the winter months is 

accompanied by frequent thaws icy phenomena, which increase the risks of death of 

rodents, including a wide species spectrum of gerbils of the genus Meriones. An 

increase in temperatures in January-February leads to an early, undulating exit from 

the hibernation of ground squirrels of the genus Spermophilus, which disrupts the rut, 

leads to the death of animals from starvation, delays the breeding period. High 

temperatures insufficient precipitation in the spring and summer months provoke dry 

winds vegetation burnout, which negatively affects the state of the rodent food supply 

and the generative potential of their populations. In the conditions of mountain and 

high-altitude landscapes, the impact of modern climate warming on the state of 

parasitic systems of the mountain and high-altitude natural plague foci due to the high 

mosaic of landscapes is less pronounced. 

  In the plague-enzootic territory of the Russian Federation, following the long-

term epizootological forecast, the preservation of a tense epidemiological situation is 

expected in the Gorno-Altai highland and Tuva mountain natural foci of the plague. 

The favorable epizootological prognosis also extends to the biological principles of 

Y. pestispestis of the medieval biovar of the phylogenetic branch 2.MED1 - 

Transcaucasian plain-foothill, Priaraxin low-mountain, and Y. pestis of the Caucasian 

subspecies of the phylogenetic branch 0.PE2 is a Transcaucasian highland located in 

the Republic of Azerbaijan, Georgia, and the Republic of Armenia. On the territory 

of the Republic of Kazakhstan, the preservation of high epizootic activity is predicted 

in the North Aral, Aral-Karakum, Balkhash, Moyinkum, Taukum desert, and Ili 

intermountain natural foci with the circulation of Y. pestispestis strains of the 

medieval biovar of the phylogenetic branch 2.MED1. In the Kyrgyz Republic, the 

development of plague epizootics was caused by Y strains. pestispestis of the 

antichnogobiovar of the phylogenetic branch 0.ANT5 is expected on the territory of 



Art of Medicine           Volume-2 

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the Saryjaz and Verkhnenarynsky high-altitude natural foci. There are no data on the 

state of natural plague foci in the Republic of Turkmenistan, the Republic of 

Uzbekistan, and the Republic of Tajikistan [1]. 

The Kyzylkum natural foci of the plague, according to 2020, covers an area of 

385,000 km2 is the most significant in epidemic terms; the territory with epidemic 

manifestations occupies 6700 km2. The most important part of the stationary objects 

of supervision of the Anti-Plague Station of the State Institution "Navoi Mining and 

Metallurgical Combine Fund" of the Republic of Uzbekistan is located on the 

territory of the Kyzylkum natural meso-plague outbreak, in its central part. 

The Kyzylkum natural plague center is localized on the physical and 

geographical district of the same name, almost in the very center of the flat part of 

Central Asia, which is associated with its truly desert landscape. It includes the 

western part (belonging to Uzbekistan) of the Kyzylkum desert (its northern and 

eastern parts are located on the territory of Kazakhstan). In the north, the district 

borders with Kazakhstan, in the southwest - with Turkmenistan, in the east is the 

Mirzachul district, in the southeast - Zarafshan and in the west — the Lower reaches 

of the Amu Darya. 

The surface of the area decreases slightly in the direction from the southeast to 

the northwest. The average height is 200-300 m; in the southeast, the size reaches 

350-400 m, in the northwest - only 100 m. The lowest point is the Mingbulak 

depression at 12 m below sea level. The highest point is the Aktau Peak (height 922 

m) of Tamdytau Mountain. 

The relief of the Kyzylkum district is diverse. There are plains, Remnant 

Mountains, and depressions located between the mountains. But most of Kyzylkum is 

made up of tables with an absolute height of up to 200 m. The central part of the plain 

is occupied by sand ridges, sandhills, dunes, takyrs. Dunes are found mainly along 

the banks of the Amu Darya and around wells. Plants anchor sand ridges and hills. 

Takyrs occupy the inter-row depressions. 

The mountains Bukantau (764 m), Auminzatau (695 m), Etymtau (571 m), 

Tamdytau (922 m), Kuljuktau (785 m), Sultan-Uwais (473 m) are located mainly in 

the central part of Kyzylkum.Between these mountains are the depressions of 

Mingbulak, Karakata, Mullali, Ayakagitma. The lowered areas of these depressions 

are occupied by salt marshes, takyrs, sand massifs. [2,3]. 

 The vegetation cover is dominated by perennial and sagebrush phytocenoses, 

psammophilic and halophilic communities are widespread, fragments of tugai 

vegetation are found. Ephemera and ephemerides with a short spring growing season 

prevail among them: bulbous bluegrass, sedge, Dantonia bonfire, tulips, snowdrops, 

ixiolirion, small-fruited cousins. Juzgun, white saxaul, Celine, sandy acacia, kandym 

grow on the fixed sands. Wormwood and weeds are common on gray-brown soils. 

Black saxaul, tamarisk, fleshy solyanka, sarisazan grow on saline, saline-marsh soils, 

and sheep's cleavage grows on takyrs. Tugai plants grow in the Amu Darya Valley. 

On the territory of the Central section of the Kyzylkums, it is noted that the 

threshold for experiencing rodent depression caused by internal mechanisms of self-

regulation was passed in 2016-2017. 2018-2020 indicates a decrease in the number of 



Art of Medicine           Volume-2 

International Medical Scientific Journal       Issue-1 

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24 

significant and minor plague carriers after the positive dynamics that appeared in 

2016-2017, concerning both reproduction and the numerical composition of rodents. 

 

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Verzhutsky, E.V. Chipanin, T.Z. Ayazbaev, A.K. Dzhaparova, S.K. Berdiev, A.A. 

Lopatin, V.M. Dubyansky, S.A. Shcherbakova, S.V. Balakhonov, A.N. 

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