Bubonic Plague Outbreak Investigation in the Endemic District of Tsiroanomandidy - Madagascar, October 2014

Rakotoarisoa A (1, 2, 3) , Ramihangihajason T (4) , Ramarokoto C (1) , Rahelinirina S (5) , Halm A (3) , Piola P (1) , Ratsitorahina M (1, 3) , Rajerison M (5)

1 IPM - Unité d'Epidémiologie [Antananarivo, Madagascar]
2 Ministère de la Santé Publique - Ministry of Public Health [Antananarivo, Madagascar]
3 Indian Ocean Commission
4 IPM - Unité d'Entomologie Médicale [Antananarivo, Madagascar]
5 Unité Peste - Plague Unit [Antananarivo, Madagascar]

Background: Plague remains a major public health problem in Madagascar. Faced with reports of plague cases and deaths in Tsiroanomandidy district, we performed an investigation in October 2014.List of Abbreviations: BHCS: Basic Health Center; CDC: Control and prevention Diseases Center; DHS: District Health Service; IPM: Institut Pasteur de Madagascar; MOH: Ministry of Health; SMZ-TMP: Sulfamethoxazole Trimethoprim; WHO: World Health Organization Methods: We used the National plague control program case definition. We identified cases from outpatient registers and collected socio-demographic and clinical information. Plague circulation was determined through a retrospective environmental survey of rodents and vectors. Results: From August 1st to October 12th 2014, we identified 30 cases of which 13 deaths in 7 out of 17 municipalities; 18 were confirmed, 6 probable, and 6 suspected cases. The sex ratio (M/F) was 4:1. Yersinia pestis was isolated from Rattus rattus in one municipality. Flea index was 2.3. We collected 45 fleas through a trap set in a house 6 hours after insecticide spraying. Our aim was to describe the plague outbreak and to improve the national plague control strategies. Conclusion: The presence of infected flea and rodent maintain the persistence of plague in the municipalities investigated. There is a high risk of plague transmission to humans. This study showed that rodent and flea information are important for plague control strategies.

Keywords: Bubonic Plague; Outbreak; Environmental Factors; Reservoirs; Vectors

Domains: Bacteriology; Santé publique et épidémiologie; Genomics [q-bio.GN]; Subcellular Processes [q-bio.SC]; Cell Behavior [q-bio.CB]; Quantitative Methods [q-bio.QM]; Animal genetics; Human genetics; Populations and Evolution [q-bio.PE]; Adaptive immunology; Innate immunity; Mycology; Protistology; Virology; Methodology [stat.ME]; Applications [stat.AP]; Biochemistry [q-bio.BM]

Rakotoarisoa A, Ramihangihajason T, Ramarokoto C, Rahelinirina S, Halm A, et al.. Bubonic Plague Outbreak Investigation in the Endemic District of Tsiroanomandidy - Madagascar, October 2014. Journal of Case Reports and Studies, 2017, 5 (1), pp.103 ⟨10.15744/2348-9820.5.103⟩. ⟨pasteur-01644147⟩