Global & Disaster Medicine

Pneumonic plague persists as a threat in Madagascar, where poor healthcare systems and traditional burial practices promote these outbreaks.

CDC-EID

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.”

Ramasindrazana B, Andrianaivoarimanana V, Rakotondramanga JM, Birdsell DN, Ratsitorahina M, Rajerison M. Pneumonic plague transmission, Moramanga, Madagascar, 2015. Emerg Infect Dis. 2017 Mar [date cited]. http://dx.doi.org/10.3201/eid2303.161406

Course of pneumonic plague outbreak in Moramanga, Madagascar, August 17–September 1, 2015 (N = 14). Each line corresponds to a case-patient and describes disease outcomes. The vertical dashed line denotes when control measures began.

 

Map of pneumonic plague outbreak (n = 14) in the commune of Ampasipotsy Gara in Moramanga, Madagascar, 2015. The index case-patient (case-patient 1) was infected with Yersinia pestis at Antsahatsianarina and spread the bacterium to Beravina (burial site of case-patient 1), Ambilona (case-patient 10’s home), and Ambatoharanana (burial site of case-patient 2 and home of case-patient 14). Each pie chart indicates the proportions of plague cases (red), seropositive contacts (blue), seronegative cont

Map of pneumonic plague outbreak (n = 14) in the commune of Ampasipotsy Gara in Moramanga, Madagascar, 2015. The index case-patient (case-patient 1) was infected with Yersinia pestis at Antsahatsianarina and spread the bacterium to Beravina (burial site of case-patient 1), Ambilona (case-patient 10’s home), and Ambatoharanana (burial site of case-patient 2 and home of case-patient 14). Each pie chart indicates the proportions of plague cases (red), seropositive contacts (blue), seronegative contacts (green), unsampled contacts (yellow), and noncontacts (brown) among the total inhabitants of each site.


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