TY - JOUR
T1 - Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017
AU - Andrianaivoarimanana, Voahangy
AU - Savin, Cyril
AU - Birdsell, Dawn N.
AU - Vogler, Amy J.
AU - Guern, Anne Sophie Le
AU - Rahajandraibe, Soloandry
AU - Brémont, Sylvie
AU - Rahelinirina, Soanandrasana
AU - Sahl, Jason W.
AU - Ramasindrazana, Beza
AU - Rakotonanahary, Rado Jean Luc
AU - Rakotomanana, Fanjasoa
AU - Randremanana, Rindra
AU - Maheriniaina, Viviane
AU - Razafimbia, Vaoary
AU - Kwasiborski, Aurelia
AU - Balière, Charlotte
AU - Ratsitorahina, Maherisoa
AU - Baril, Laurence
AU - Keim, Paul
AU - Caro, Valérie
AU - Rasolofo, Voahangy
AU - Spiegel, André
AU - Pizarro-Cerda, Javier
AU - Wagner, David M.
AU - Rajerison, Minoarisoa
N1 - Publisher Copyright:
© 2024 Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2024/2
Y1 - 2024/2
N2 - Pneumonic plague (PP) is characterized by high infection rate, person-to-person transmission, and rapid progression to severe disease. In 2017, a PP epidemic occurred in 2 Madagascar urban areas, Antananarivo and Toamasina. We used epidemiologic data and Yersinia pestis genomic characterization to determine the sources of this epidemic. Human plague emerged independently from environmental reservoirs in rural endemic foci >20 times during August–November 2017. Confirmed cases from 5 emergences, including 4 PP cases, were documented in urban areas. Epidemiologic and genetic analyses of cases associated with the first emergence event to reach urban areas confirmed that transmission started in August; spread to Antananarivo, Toamasina, and other locations; and persisted in Antananarivo until at least mid-November. Two other Y. pestis lineages may have caused persistent PP transmission chains in Antananarivo. Multiple Y. pestis lineages were independently introduced to urban areas from several rural foci via travel of infected persons during the epidemic.
AB - Pneumonic plague (PP) is characterized by high infection rate, person-to-person transmission, and rapid progression to severe disease. In 2017, a PP epidemic occurred in 2 Madagascar urban areas, Antananarivo and Toamasina. We used epidemiologic data and Yersinia pestis genomic characterization to determine the sources of this epidemic. Human plague emerged independently from environmental reservoirs in rural endemic foci >20 times during August–November 2017. Confirmed cases from 5 emergences, including 4 PP cases, were documented in urban areas. Epidemiologic and genetic analyses of cases associated with the first emergence event to reach urban areas confirmed that transmission started in August; spread to Antananarivo, Toamasina, and other locations; and persisted in Antananarivo until at least mid-November. Two other Y. pestis lineages may have caused persistent PP transmission chains in Antananarivo. Multiple Y. pestis lineages were independently introduced to urban areas from several rural foci via travel of infected persons during the epidemic.
UR - http://www.scopus.com/inward/record.url?scp=85183583804&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85183583804&partnerID=8YFLogxK
U2 - 10.3201/eid3002.230759
DO - 10.3201/eid3002.230759
M3 - Article
C2 - 38270131
AN - SCOPUS:85183583804
SN - 1080-6040
VL - 30
SP - 289
EP - 298
JO - Emerging infectious diseases
JF - Emerging infectious diseases
IS - 2
ER -