Plague Outbreak in Libya, 2009, Unrelated to Plague in Algeria

Abstract

After 25 years of no cases of plague, this disease recurred near Tobruk, Libya, in 2009. An epidemiologic investigation identified 5 confirmed cases. We determined ribotypes, Not1 restriction profiles, and IS100 and IS1541 hybridization patterns of strains isolated during this outbreak. We also analyzed strains isolated during the 2003 plague epidemic in Algeria to determine whether there were epidemiologic links between the 2 events. Our results demonstrate unambiguously that neighboring but independent plague foci coexist in Algeria and Libya. They also indicate that these outbreaks were most likely caused by reactivation of organisms in local or regional foci believed to be dormant (Libya) or extinct (Algeria) for decades, rather than by recent importation of Yersinia pestis from distant foci. Environmental factors favorable for plague reemergence might exist in this area and lead to reactivation of organisms in other ancient foci.

Upsurge of Rodents’ Population in a Rural Area of Northeastern Iran Raised Concerns about Rodent-borne Diseases

“…In some parts of the world, rodents are still the reservoirs of human plague and are considered a threat to the public health [4]. After decades of disappearance, plague outbreaks occurred in Algeria (2003) and Libya (2009), and southern Afghanistan [5][6][7]. During 2014 to 2015, 308 cases of plague with 81 deaths (27% mortality) were reported from Madagascar [8].…”

Current perspectives on the spread of plague in Africa

“…The Democratic Republic of the Congo and Madagascar are the countries with the highest endemicity in the world. 18,19 Active foci of human plague in Africa are known to exist in Algeria, 21 Democratic Republic of the Congo, 12 Libya, 22 Madagascar, 19 Mozambique, 23 Tanzania, 24 Uganda, 23 and Zambia (Figure 1). 25 In addition, Africa includes countries with a history of human plague and possibly zoonotic foci are currently present.…”

“…A more recent plague epidemic was reported in 2011 in the city of Tobruk. 22 Human plague was first introduced into Madagascar in the coastal city Toamasina in 1898, 86 most probably via infected rats on steam ships from India. 87 Outbreaks in other coastal cities were then reported.…”

Real-time qPCR Assay Development for Detection of Bacillus thuringiensis and Serratia marcescens DNA and the Influence of Complex Microbial Community DNA on Assay Sensitivity

“…The outbreak was eventually controlled when treatment with tetracycline hydrochloride proved effective and was administered to patients en masse (Nandan 1994). Other outbreaks arose as recently as 2003 in Algeria (Bertherat et al 2007) and 2009 in Libya (Cabanel et al 2013). Although outbreaks like these have occurred recently and frequently, the availability of effective antibiotics in the past several decades has significantly reduced the impact of the disease on human populations (Cabanel et al 2013).…”

“…Other outbreaks arose as recently as 2003 in Algeria (Bertherat et al 2007) and 2009 in Libya (Cabanel et al 2013). Although outbreaks like these have occurred recently and frequently, the availability of effective antibiotics in the past several decades has significantly reduced the impact of the disease on human populations (Cabanel et al 2013). As a consequence of the deadly effects of plague infection in humans, Y. pestis is also considered to have dangerous potential as a biological warfare agent (Prentice and Rahalison 2007 (Kadlec et al 1997).…”