Pneumonic Plague Outbreak, Northern Madagascar, 2011

Richard, Vincent; Riehm, Julia M.; Herindrainy, Perlinot; Rahelinirina, Soanandrasana; Ratsitoharina, M.; Rakotomanana, Fanjasoa; Andrianalimanana, Samuel; Scholz, Holger C.; Rajerison, Minoarisoa

doi:10.3201/eid2101.131828

Cited by 36 publications

(46 citation statements)

References 24 publications

(42 reference statements)

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“…While present-day outbreaks involve far fewer cases, they are still of concern, especially since around 10% of bubonic plague cases proceed to the pneumonic form, which both spreads more easily and is much harder to treat given its rapidly manifested severity (1). Indeed, a recent outbreak in Madagascar is associated with 263 cases and 71 deaths, and a previous outbreak in 2011 involved the pneumonic form (2). In addition, antibiotic resistance to Y. pestis has been documented and there is no vaccine currently licensed for the prevention of plague in the Western world (3).…”

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confidence: 99%

Resistance of Mice of the 129 Background to Yersinia pestis Maps to Multiple Loci on Chromosome 1

Tencati

Tapping

2016

Infect Immun

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Yersinia pestis is a Gram-negative bacterium that is the causative agent of bubonic and pneumonic plague. It is commonly acquired by mammals such as rodents and humans via the bite of an infected flea. We previously reported that multiple substrains of the 129 mouse background are resistant to pigmentation locus-negative (pgm ؊ ) Yersinia pestis and that this phenotype maps to a 30-centimorgan (cM) region located on chromosome 1. In this study, we have further delineated this plague resistance locus to a region of less than 20 cM through the creation and phenotyping of recombinant offspring arising from novel crossovers in this region. Furthermore, our experiments have revealed that there are at least two alleles in this initial locus, both of which are required for resistance on a susceptible C57BL/6 background. These two alleles work in trans since resistance is restored in offspring possessing one allele contributed by each parent. Our studies also indicated that the Slc11a1 gene (formerly known as Nramp1) located within the chromosome1 locus is not responsible for conferring resistance to 129 mice.

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confidence: 99%

Resistance of Mice of the 129 Background to Yersinia pestis Maps to Multiple Loci on Chromosome 1

Tencati

Tapping

2016

Infect Immun

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“…Serologisch bestätigt wurden 167 Fälle, und 53 Patienten verstarben an der Lungen-oder Beulenpest [10]. Seitdem sind in den Verbreitungsgebieten zahlreiche kleinere Ausbrüche von Beulen-und Lungenpest aufgetreten, insbesondere in Madagaskar und in der Demokratischen Republik Kongo [8,[11][12][13].…”

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“…Nur bei einem kleinen Teil der Meldefälle handelte es sich um Lungenpest, deren Anteil -soweit hierzu Daten vorliegen -zwischen weniger als 1 % und bis zu 5 % schwankt. Bei den gefürchteten Ausbrüchen von primä-rer Lungenpest kann dieser Anteil jedoch auf bis zu 100 % ansteigen [11][12][13].…”

Section: Erregerunclassified

“…Im Gegensatz zu anderen akuten bakteriellen Pneumonien fallen bei einigen Patienten mediastinale und hiläre Lymphadenitiden auf. Die Lungenpest verläuft rasch tödlich, wenn nicht umgehend eine adäquate antimikrobielle Therapie erfolgt [8,11,36].…”

Section: Pathogenese Und Krankheitsbilderunclassified

“…Die Gefahr, die von multiresistenten Isolaten ausgeht, ist schwer einzuschätzen. Pestepidemien in der präantibiotischen Ära bis 1920 hatten bei Weitem verheerendere Folgen als Pestausbrüche, die sich in den letzten Jahrzehnten ereigneten [9,11] [41]. Lungenpestfälle sind wegen der hohen Kontagiosität in einer der Sonderisolierstationen zu behandeln, die in den derzeit sieben deutschen Kompetenz-und Behandlungszentren für hochkontagiö-se und lebensbedrohliche Erkrankungen zur Verfügung stehen.…”

Section: Therapieunclassified

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Pest und Lungenpest

Riehm

Löscher²

2015

Bundesgesundheitsbl.

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Yersinia pestis is a highly pathogenic gram-negative bacterium and the causative agent of human plague. In the last 1500 years and during three dreaded pandemics, millions of people became victims of Justinian's plague, the Black Death, or modern plague. Today, Y. pestis is endemic in natural foci of Asian, African and American countries. Due to its broad dissemination in mammal species and fleas, eradication of the pathogen will not be possible in the near future. In fact, plague is currently classified as a "re-emerging disease". Infection may occur after the bite of an infected flea, but also after oral ingestion or inhalation of the pathogen. The clinical presentations comprise the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Most human cases can successfully be treated with antibiotics. However, the high transmission rate and lethality of pneumonic plague require international and mandatory case notification and quarantine of patients. Rapid diagnosis, therapy and barrier nursing are not only crucial for the individual patient but also for the prevention of further spread of the pathogen or of epidemics. Therefore, WHO emergency schedules demand the isolation of cases, identification and surveillance of contacts as well as control of zoonotic reservoir animals and vectors. These sanctions and effective antibiotic treatment usually allow a rapid containment of outbreaks. However, multiple antibiotic resistant strains of Y. pestis have been isolated from patients in the past. So far, no outbreaks with such strains have been reported.

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Rapid diagnostic tests for plague

Jullien

Dissanayake

Chaplin

2020

Cochrane Database of Systematic Reviews

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BackgroundPlague is a severe disease associated with high mortality. Late diagnosis leads to advance stage of the disease with worse outcomes and higher risk of spread of the disease. A rapid diagnostic test (RDT) could help in establishing a prompt diagnosis of plague. This would improve patient care and help appropriate public health response. ObjectivesTo determine the diagnostic accuracy of the RDT based on the antigen F1 (F1RDT) for detecting plague in people with suspected disease. Search methodsWe searched the CENTRAL, Embase, Science Citation Index, Google Scholar, the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov up to 15 May 2019, and PubMed (MEDLINE) up to 27 August 2019, regardless of language, publication status, or publication date. We handsearched the reference lists of relevant papers and contacted researchers working in the field. Selection criteriaWe included cross-sectional studies that assessed the accuracy of the F1RDT for diagnosing plague, where participants were tested with both the F1RDT and at least one reference standard. The reference standards were bacterial isolation by culture, polymerase chain reaction (PCR), and paired serology (this is a four-fold di erence in F1 antibody titres between two samples from acute and convalescent phases). Data collection and analysisTwo review authors independently selected studies and extracted data. We appraised the methodological quality of each selected studies and applicability by using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. When meta-analysis was appropriate, we used the bivariate model to obtain pooled estimates of sensitivity and specificity. We stratified all analyses by the reference standard used and presented disaggregated data for forms of plague. We assessed the certainty of the evidence using GRADE. Main resultsWe included eight manuscripts reporting seven studies. Studies were conducted in three countries in Africa among adults and children with any form of plague. All studies except one assessed the F1RDT produced at the Institut Pasteur of Madagascar (F1RDT-IPM) and one study assessed a F1RDT produced by New Horizons (F1RDT-NH), utilized by the US Centers for Disease Control and Prevention. We could not pool the findings from the F1RDT-NH in meta-analyses due to a lack of raw data and a threshold of the test for positivity di erent from the F1RDT-IPM.

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Pneumonic Plague Outbreak, Northern Madagascar, 2011

Abstract: Multidrug-resistant Yersinia pestis is a serious threat that requires outbreak response strategies.

Cited by 36 publications

References 24 publications

Resistance of Mice of the 129 Background to Yersinia pestis Maps to Multiple Loci on Chromosome 1

Resistance of Mice of the 129 Background to Yersinia pestis Maps to Multiple Loci on Chromosome 1

Pest und Lungenpest

Rapid diagnostic tests for plague

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