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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

Table 2

Information on 29 case-patients associated with the first known urban pneumonic plague transmission chain, Madagascar, August–November 2017*

Case-patient no. Age, y/sex Outcome Onset date Onset district Onset location Travel Documented contact with other case-patients Sample/positive Y. pestis result Case definition
1
 32/M
 Died
 Aug 25
 Ankazobe
 Rural
 Yes
 2, 3, 5
 No samples collected
 Suspected
2
 26/M
 Died
 Sep 1
 Toamasina I
 Urban
 Yes
 1, 3, 5, 20, 22
 No samples collected
 Suspected
3
 36/M
 Died
 Sep 2
 Toamasina I
 Urban
 Yes
 1, 2, 4, 5, 7
 No samples collected
 Suspected
4
 23/F
 Recovered
 Sep 5
 Toamasina I
 Urban
 No
 3, 5, 7
 Sputum 135–2017/RDT, PCR
 Probable
5
 16/F
 Died
 Sep 6
 Antananarivo-Renivohitra
 Urban
 Yes
 1, 3, 4, 6, 7, 8, 9, 12, 13, 14, 15, 16, 17, 18, 19, 21, 24, 28
 No samples collected
 Suspected
6
 47/F
 Died
 Sep 9
 Antananarivo-Renivohitra
 Urban
 Yes
 5, 8, 9, 10, 11, 12, 21, 25, 28, 29
 Sputum 118–2017/RDT, PCR
 Probable
7
 40/F
 Recovered
 Sep 6
 Mahajanga I
 Urban
 Yes
 3, 4, 5
 Sputum 121–2017/culture yielded isolate 17/17
 Confirmed
8
 45/M
 Recovered
 Sep 9
 Antananarivo-Renivohitra
 Urban
 No
 5, 6, 9, 12, 21, 28
 Sputum 150–2017/RDT
 Probable
9
 30/M
 Recovered
 Sep 5
 Tsiroanomandidy
 Rural
 Yes
 5, 6, 8, 12, 21, 28
 Sputum 143–2017/RDT
 Probable
10
 21/F
 Recovered
 Sep 11
 Antananarivo-Renivohitra
 Urban
 No
 6, 11, 29
 Sputum 119–2017/no positive tests
 Suspect
11
 15/M
 Recovered
 Sep 11
 Antananarivo-Renivohitra
 Urban
 No
 6, 10, 29
 Sputum 120–2017/no positive tests
 Suspected
12
 37/M
 Recovered
 Sep 11
 Miarinarivo
 Rural
 Yes
 5, 6, 8, 9, 21, 28
 Sputum 153–2017/RDT
 Probable
13
 11/F
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 14, 15, 16, 17, 18, 19, 24
 No samples collected
 Suspected
14
 52/M
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 15, 16, 17, 18, 19, 24
 Sputum 124–2017/RDT, PCR
 Probable
15
 48/F
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 14, 16, 17, 18, 19, 24
 Sputum 125–2017/RDT, PCR
 Probable
16
 9/F
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 14, 15, 17, 18, 19, 24
 No samples collected
 Suspected
17
 39/F
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 14, 15, 16, 18, 19, 24
 No samples collected
 Suspected
18
 38/F
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 14, 15, 16, 17, 19, 24
 Sputum 129–2017/RDT
 Probable
19
 19/M
 Recovered
 Sep 12
 Faratsiho
 Rural
 No
 5, 13, 14, 15, 16, 17, 18, 24
 No samples collected
 Suspected
20
 25/M
 Recovered
 Sep 12
 Toamasina I
 Urban
 No
 2
 Sputum 136–2017/RDT
 Probable
21
 31/M
 Recovered
 Sep 12
 Toamasina I
 Urban
 Yes
 5, 6, 8, 9, 12, 28
 Sputum 149–2017/RDT, PCR
 Probable
22
 30/M
 Recovered
 Sep 6
 Vohemar
 Rural
 Yes
 2, 23
 Sputum 184–2017/RDT
 Probable
23
 33/M
 Recovered
 Sep 15
 Vohemar
 Rural
 No
 22
 Sputum 185–2017/RDT
 Probable
24
 UNK/F
 Recovered
 Sep 13
 Faratsiho
 Rural
 No
 5, 13, 14, 15, 16, 17, 18, 19
 Sputum 131–2017/no positive tests
 Suspected
25
 49/M
 Recovered
 Sep 14
 Antananarivo-Renivohitra
 Urban
 No
 6
 Blood 188–2017/RDT
 Probable
26
 13/M
 Recovered
 Sep 14
 Faratsiho
 Rural
 No
 ≥1 of 13, 14, 15, 16, 17, 18, 19, 24
 Sputum 133–2017/RDT, PCR
 Probable
27
 39/M
 Recovered
 Sep 14
 Faratsiho
 Rural
 No
 ≥1 of 13, 14, 15, 16, 17, 18, 19, 24
 Sputum 134–2017/no positive tests
 Suspected
28
 25/F
 Recovered
 Sep 17
 Ambohidratrimo
 Rural
 Yes
 5, 6, 8, 9, 12, 21
 Sputum 164–2017/no positive tests
 Suspected
29 46/F Recovered Sep 10 Antananarivo-Renivohitra Urban No 6, 10, 11 Sputum 181–2017/RDT Probable

*UNK, unknown.

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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