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Volume 30, Number 2—February 2024
Research

Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017

Voahangy Andrianaivoarimanana1, Cyril Savin1, Dawn N. Birdsell1, Amy J. Vogler, Anne-Sophie Le Guern, Soloandry Rahajandraibe, Sylvie Brémont, Soanandrasana Rahelinirina, Jason W. Sahl, Beza Ramasindrazana, Rado Jean Luc Rakotonanahary, Fanjasoa Rakotomanana, Rindra Randremanana, Viviane Maheriniaina, Vaoary Razafimbia, Aurelia Kwasiborski, Charlotte Balière, Maherisoa Ratsitorahina, Laurence Baril, Paul Keim, Valérie Caro, Voahangy Rasolofo, André Spiegel, Javier Pizarro-Cerda2, David M. Wagner2, and Minoarisoa Rajerison2Comments to Author 
Author affiliations: Institut Pasteur de Madagascar, Antananarivo, Madagascar (V. Andrianaivoarimanana, S. Rahelinirina, B. Ramasindrazana, R.J.L. Rakotonanahary, F. Rakotomanana, R. Randremanana, M. Ratsitorahina, L. Baril, V. Rasolofo, A. Spiegel, M. Rajerison); Institut Pasteur, Paris, France (C. Savin, A.-S. Le Guern, S. Brémont, A. Kwasiborski, C. Balière, V. Caro, J. Pizarro-Cerda); Northern Arizona University, Flagstaff, Arizona, USA (D.N. Birdsell, A.J. Vogler, J.W. Sahl, P. Keim, D.M. Wagner); Madagascar Ministry of Public Health, Antananarivo (S. Rahajandraibe, V. Maheriniaina, V. Razafimbia)

Main Article

Figure 1

Plague emergence in Madagascar, August–November 2017. A) Locations of emergences. Gray shading indicates plague-endemic regions in the central and northern highlands; yellow shading indicates 12 districts from which human plague emerged from environmental reservoirs 20 times during August–November 2017. Districts are listed in chronological order of emergences. Multiple numbers in the list correspond to different independent emergences from the same district (Table 1); only the first number is indicated on the map. Black box indicates the area shown in panel B. B) Movements (red arrows) of some of the cases (Table 2) associated with the first urban pneumonic plague transmission chain (emergence 2 in Table 1). Blue polygons indicate districts of origin/destination for travel; blue circles indicate the cities of Moramanga and Toamasina.

Figure 1. Plague emergence in Madagascar, August–November 2017. A) Locations of emergences. Gray shading indicates plague-endemic regions in the central and northern highlands; yellow shading indicates 12 districts from which human plague emerged from environmental reservoirs 20 times during August–November 2017. Districts are listed in chronological order of emergences. Multiple numbers in the list correspond to different independent emergences from the same district (Table 1); only the first number is indicated on the map. Black box indicates the area shown in panel B. B) Movements (red arrows) of some of the cases (Table 2) associated with the first urban pneumonic plague transmission chain (emergence 2 in Table 1). Blue polygons indicate districts of origin/destination for travel; blue circles indicate the cities of Moramanga and Toamasina.

Main Article

1These authors contributed equally to this article.

2These senior authors contributed equally to this article.

Page created: December 31, 2023
Page updated: January 24, 2024
Page reviewed: January 24, 2024
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