Current perspectives on the spread of plague in Africa

Lotfy, Wael M.

doi:10.2147/rrtm.s63522

Cited by 11 publications

(12 citation statements)

References 87 publications

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“…However, it is known that after long periods of epidemiological silence, there is the possibility of reemergence (Stenseth et al 2008). As recently reported in foci in Africa (Malek et al 2014), the region is currently responsible for over 90% of the cases registered every year (Raoult et al 2013), and where several countries do not register any recent activity and are strong candidates for reemergence (Lotfy 2015).…”

Section: Discussionmentioning

confidence: 96%

“…Although Plague has experienced a decrease in activity during the last century, it is still a present threat. Areas such as sub-Saharan Africa have been detecting activity in foci that were quiescent for decades (Malek et al 2014, Lotfy 2015). The new cases detected in foci considered dormant for over 30 years has caused the WHO to classify Plague as a re-emerging disease (Richgels et al 2016) and Brazilian foci are likely to resume activity as well (Zeppelini et al 2016).…”

Section: Discussionmentioning

confidence: 99%

“…However, long dormant foci can reemerge (Stenseth et al 2008), as it has been recently reported in African foci (Malek et al 2014), a region that concentrates 90% of the current cases (Raoult et al 2013), and where several CAIO G. ZEPPELINI, ALZIRA M.P. DE ALMEIDA and PEDRO CORDEIRO-ESTRELA countries and regions that do not present recent activity might potentially rekindle (Lotfy 2015).…”

Section: Introductionmentioning

confidence: 88%

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Ongoing quiescence in the Borborema Plateau Plague focus (Paraiba, Brazil)

Zeppelini

Almeida

Cordeiro‐Estrela

2018

An. Acad. Bras. Ciênc.

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Plague is a zoonosis caused by Yersinia pestis, whose cycle is based on a reservoir system composed of mammals and their fleas. Its transmission cycle presents long enzootic periods with undetected cases, sometimes misleading that the cycle is extinct. While surveillance activities in Brazil are being carried out only in some focal areas, the serologic results confirm the persistence of Y. pestis in all monitored areas. We studied the small mammal assembly and Y. pestis presence in the Borborema Plateau Focus within the state of Paraíba, which staged the last Brazilian plague outbreak (1986-1987), through an inventory and Y. pestis detection survey of small mammals in peridomestic and sylvatic areas from two municipalities in the state of Paraíba. The field sampling captured 45 specimens (27 marsupials, 18 rodents), of 10 species. Only two species (one marsupial, one rodent) were captured in both peridomestic and sylvatic ecotopes. The sylvatic ecotope had higher richness and abundance. No evidence of circulation of the pathogen was detected, however, this result does not discard the necessity of continuous epidemiological surveillance due to the risk of rekindling the foci after long dormant periods, especially given the current epidemiological transition occurring on a Global scale.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

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Ongoing quiescence in the Borborema Plateau Plague focus (Paraiba, Brazil)

Zeppelini

Almeida

Cordeiro‐Estrela

2018

An. Acad. Bras. Ciênc.

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“…Also the new outbreaks in Madagascar confirm that human plague can be considered an infectious disease reemerging in XXI Century. On the other hand, in a study concerning perspectives on the spread of the plague in Africa it was concluded that all African countries should be concerned by the possible emergence and reemergence of the disease and that it is crucial to implement some preventive measures in these countries [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Plague: A Millenary Infectious Disease Reemerging in the XXI Century

Grácio

2017

BioMed Research International

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Plague, in the Middle Ages known as Black Death, continues to occur at permanent foci in many countries, in Africa, Asia, South America, and even the USA. During the last years outbreaks were reported from at least 3 geographical areas, in all cases after tens of years without reported cases. The recent human plague outbreaks in Libya and Algeria suggest that climatic and other environmental changes in Northern Africa may be favourable for Y. pestis epidemiologic cycle. If so, other Northern Africa countries with plague foci also may be at risk for outbreaks in the near future. It is important to remember that the danger of plague reoccurrence is not limited to the known natural foci, for example, those of Algeria, Angola, and Madagascar. In a general context, it is important that governments know the dangerous impact that this disease may have and that the health and medical community be familiar with the epidemiology, symptoms, treatment, and control of plague, so an appropriated and timely response can be delivered should the worst case happen. Plague can be used as a potential agent of bioterrorism. We have concluded that plague is without a doubt a reemerging infectious disease.

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“…Historical documentation of plague in Africa dates back to the early 1900s [20], though it likely occurred well before then. These outbreaks have ranged in size from dozens to thousands of cases [21]. A 2017 outbreak in Madagascar ultimately affected over 2,000 persons, with 202 deaths (case-fatality rate = 8.6%) [19]; this outbreak spread quickly in part due to a weak surveillance system [23].…”

Section: Funding and Disclaimermentioning

confidence: 99%

Fatal Cross-Border Plague in Zombo District, Uganda, March 2019

Gonahasa¹,

Amia²,

Basuta³

et al. 2020

Preprint

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Background: Plague, which is caused by Yersinia pestis, is a priority zoonotic disease targeted for elimination in Uganda. Untreated bubonic plague, resulting from a flea bite, can develop into pneumonic plague, or pneumonic plague may be transmitted in respiratory droplets from person to person. On 6 March 2019, the Uganda Ministry of Health was notified of a patient in Zombo District with clinical presentation similar to pneumonic plague, and a positive plague rapid diagnostic test (RDT). The patient had family links to the Democratic Republic of Congo (DRC). We determined the scope of the outbreak, determined the mode of transmission, and recommended evidence-based control and prevention measures.Methods: A suspected pneumonic plague case was ≥2 of: cough (bloody or wet), chest pain, difficulty in breathing, or fever in a resident of Zombo District during February 1-March 31, 2019. A confirmed case was a suspected case testing positive for Yersinia pestis by rapid diagnostic test, culture or serology. We actively searched for case-patients, traced contacts and took samples as appropriate. We performed descriptive epidemiology of the outbreak.Results: We identified one suspected and one confirmed pneumonic plague case. On February 26, 2019, a 4-year-old boy was buried in DRC near the Uganda border after reportedly succumbing to a disease consistent with bubonic plague. Case-patient A (35-year-old mother to the boy), fell ill with suspected pneumonic plague while attending to him. She was referred to a health facility in Uganda on February 28 but died on arrival. On March 4, Case-patient B (23-year-old sister to Case-patient A), who attended to Case-patient A, presented with pneumonic plague symptoms to the same Uganda facility and tested plague-positive by RDT, culture, and serological tests. Contacts (n=114) were traced and given antibiotics as prophylaxis; no new cases were reported.Conclusion: This fatal plague outbreak started as bubonic and later manifested as pneumonic. There was cross-border spread from DRC to Uganda with no cross-border efforts at prevention and control. Person-to-person transmission appears to have occurred. The quick and effective response likely minimized spread.

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Current perspectives on the spread of plague in Africa

Cited by 11 publications

References 87 publications

Ongoing quiescence in the Borborema Plateau Plague focus (Paraiba, Brazil)

Ongoing quiescence in the Borborema Plateau Plague focus (Paraiba, Brazil)

Plague: A Millenary Infectious Disease Reemerging in the XXI Century

Fatal Cross-Border Plague in Zombo District, Uganda, March 2019

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