Epidemiologic features of four successive annual outbreaks of bubonic plague in Mahajanga, Madagascar

From 1995 to 1998, outbreaks of bubonic plague occurred annually in the coastal city of Mahajanga, Madagascar. A total of 1,702 clinically suspected cases of bubonic plague were reported, including 515 laboratory confirmed by Yersinia pestis isolation (297), enzyme-linked immunosorbent assay, or bot...

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Published inEmerging infectious diseases Vol. 8; no. 3; pp. 311 - 316
Main Authors Boisier, Pascal, Rahalison, Lila, Rasolomaharo, Monique, Ratsitorahina, Maherisoa, Mahafaly, Mahafaly, Razafimahefa, Maminirana, Duplantier, Jean-Marc, Ratsifasoamanana, Lala, Chanteau, Suzanne
Format Journal Article
LanguageEnglish
Published United States U.S. National Center for Infectious Diseases 01.03.2002
Centers for Disease Control and Prevention
Subjects
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Analysis
Child
Child, Preschool
Disease Outbreaks
Disease susceptibility
Dispatch
epidemiology
Evaluation
Female
Humans
Incidence
Madagascar
Madagascar - epidemiology
Male
Middle Aged
Observational studies
Plague
Plague - diagnosis
Plague - epidemiology
Public health
Sex Distribution
urban outbreak
Urban Population
Yersinia pestis
Yersinia pestis - isolation & purification
Madagascar
France
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Summary:From 1995 to 1998, outbreaks of bubonic plague occurred annually in the coastal city of Mahajanga, Madagascar. A total of 1,702 clinically suspected cases of bubonic plague were reported, including 515 laboratory confirmed by Yersinia pestis isolation (297), enzyme-linked immunosorbent assay, or both. Incidence was higher in males and young persons. Most buboes were inguinal, but children had a higher frequency of cervical or axillary buboes. Among laboratory-confirmed hospitalized patients, the case-fatality rate was 7.9%, although all Y. pestis isolates were sensitive to streptomycin, the recommended antibiotic. In this tropical city, plague outbreaks occur during the dry and cool season. Most cases are concentrated in the same crowded and unsanitary districts, a result of close contact among humans, rats, and shrews. Plague remains an important public health problem in Madagascar, and the potential is substantial for spread to other coastal cities and abroad.
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ISSN:1080-6040
1080-6059
DOI:10.3201/eid0803.010250