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      Pneumonic Plague Transmission, Moramanga, Madagascar, 2015

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          Abstract

          During a pneumonic plague outbreak in Moramanga, Madagascar, we identified 4 confirmed, 1 presumptive, and 9 suspected plague case-patients. Human-to-human transmission among close contacts was high (reproductive number 1.44) and the case fatality rate was 71%. Phylogenetic analysis showed that the Yersinia pestis isolates belonged to group q3, different from the previous outbreak.

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          Yersinia pestis--etiologic agent of plague.

          R Perry, J. Fetherston (1997)
          Plague is a widespread zoonotic disease that is caused by Yersinia pestis and has had devastating effects on the human population throughout history. Disappearance of the disease is unlikely due to the wide range of mammalian hosts and their attendant fleas. The flea/rodent life cycle of Y. pestis, a gram-negative obligate pathogen, exposes it to very different environmental conditions and has resulted in some novel traits facilitating transmission and infection. Studies characterizing virulence determinants of Y. pestis have identified novel mechanisms for overcoming host defenses. Regulatory systems controlling the expression of some of these virulence factors have proven quite complex. These areas of research have provide new insights into the host-parasite relationship. This review will update our present understanding of the history, etiology, epidemiology, clinical aspects, and public health issues of plague.
          Article 0 comments Cited 305 times – based on 0 reviews     Review now
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            Development and testing of a rapid diagnostic test for bubonic and pneumonic plague.

            Elisabeth Carniel, Lala Ratsifasoamanana, Suzanne Chanteau … (2003)
            Plague is often fatal without prompt and appropriate treatment. It affects mainly poor and remote populations. Late diagnosis is one of the major causes of human death and spread of the disease, since it limits the effectiveness of control measures. We aimed to develop and assess a rapid diagnostic test (RDT) for plague. We developed a test that used monoclonal antibodies to the F1 antigen of Yersinia pestis. Sensitivity and specificity were assessed with a range of bacterial cultures and clinical samples, and compared with findings from available ELISA and bacteriological tests for plague. Samples from patients thought to have plague were tested with the RDT in the laboratory and by health workers in 26 pilot sites in Madagascar. The RDT detected concentrations of F1 antigen as low as 0.5 ng/mL in up to 15 min, and had a shelf life of 21 days at 60 degrees C. Its sensitivity and specificity were both 100%. RDT detected 41.6% and 31% more positive clinical specimens than did bacteriological methods and ELISA, respectively. The agreement rate between tests done at remote centres and in the laboratory was 89.8%. With the combination of bacteriological methods and F1 ELISA as reference standard, the positive and negative predictive values of the RDT were 90.6% and 86.7%, respectively. Our RDT is a specific, sensitive, and reliable test that can easily be done by health workers at the patient's bedside, for the rapid diagnosis of pneumonic and bubonic plague. This test will be of key importance for the control of plague in endemic countries.
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              Understanding the Persistence of Plague Foci in Madagascar

              Voahangy Andrianaivoarimanana, Katharina Kreppel, Nohal Elissa … (2013)
              Plague, a zoonosis caused by Yersinia pestis, is still found in Africa, Asia, and the Americas. Madagascar reports almost one third of the cases worldwide. Y. pestis can be encountered in three very different types of foci: urban, rural, and sylvatic. Flea vector and wild rodent host population dynamics are tightly correlated with modulation of climatic conditions, an association that could be crucial for both the maintenance of foci and human plague epidemics. The black rat Rattus rattus, the main host of Y. pestis in Madagascar, is found to exhibit high resistance to plague in endemic areas, opposing the concept of high mortality rates among rats exposed to the infection. Also, endemic fleas could play an essential role in maintenance of the foci. This review discusses recent advances in the understanding of the role of these factors as well as human behavior in the persistence of plague in Madagascar.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): March 2017
                Volume: 23
                Issue: 3
                Pages: 521-524
                Affiliations
                [1]Institut Pasteur de Madagascar, Antananarivo, Madagascar (B. Ramasindrazana, V. Andrianaivoarimanana, J.M. Rakotondramanga, M. Rajerison);
                [2]Northern Arizona University, Flagstaff, Arizona, USA (D.N. Birdsell);
                [3]Ministry of Public Health, Antananarivo (M. Ratsitorahina)
                Author notes
                Address for correspondence: Minoarisoa Rajerison, Plague Unit, Institut Pasteur de Madagascar, BP 1274 Ambatofotsikely Antananarivo-101, Madagascar; email: mino@ 123456pasteur.mg
                Article
                Publisher ID: 16-1406
                DOI: 10.3201/eid2303.161406
                PMC ID: 5382734
                PubMed ID: 28221119
                SO-VID: fbeb0fd6-401f-42d1-b1f8-8d8aef396260
                History
                Categories
                Subject: Dispatch
                Subject: Dispatch
                Subject: Pneumonic Plague Transmission, Moramanga, Madagascar, 2015

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: yersinia pestis,pneumonic plague,transmission,madagascar,outbreak,bubonic plague,vector-borne infections,bacteria
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: yersinia pestis, pneumonic plague, transmission, madagascar, outbreak, bubonic plague, vector-borne infections, bacteria

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