Re: Plague in Libya & Ministry of Health in Egypt is Preparing Procedures
Re: Plague in Libya & Ministry of Health in Egypt is Preparing Procedures
We knew this was coming
This article does mention several other (natural) scenarios that could produce a large plague outbreak (infected meat, etc.).
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,77994
PLAGUE, BUBONIC - LIBYA: (AL BUTNAN)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Tue 16 Jun 2009
Source: Reuters [edited]
<http://www.reuters.com/article/healthNews/idUSTRE55F42820090616>
Libyan authorities have reported an outbreak of bubonic plague in the
Mediterranean coastal town of Tubruq, and the World Health
Organization (WHO) was sending a team to investigate, a WHO official
said on Tuesday [16 Jun 2009].
The cases, approximately 16 to 18 have been reported, would be the
1st in more than 2 decades in Libya of the disease known in medieval
times as the Black Death, according to John Jabbour, a Cairo-based
emerging diseases specialist at WHO.
"It is reported as bubonic plague," Jabbour said, adding WHO still
didn't have "a full picture" of the situation. "It is officially
reported by Libya... Tomorrow [17 Jun 2009], the WHO is deploying a
mission to Libya to investigate the whole situation, to see how many
of the cases are confirmed, or not confirmed."
He said preliminary information from Libyan authorities showed 16 to
18 reported cases including one death, and that Tripoli had asked for
assistance from the global health body.
Tubruq, where the new cases were reported, is approximately 125 km
[78 miles] from the Egyptian border and was the scene of previous
plague cases decades ago, Jabbour said. Egypt, already fighting to
contain an outbreak of the H1N1 flu virus, said it had no reported
cases of plague.
Globally the WHO reports about 1000 to 3000 plague cases each year,
with most in the last 5 years occurring in Madagascar, Tanzania,
Mozambique, Malawi, Uganda and the Democratic Republic of Congo. The
USA sees about 10 to 20 cases each year.
[Byline: Cynthia Johnston]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Tobruk or Tubruq is a town, seaport, and peninsula in northeastern
Libya, near the border with Egypt, in North Africa. It is the capital
of Al Butnan District (formerly Tobruk District). Its location can be
found on a map at:
<http://en.wikipedia.org/wiki/Tobruk>
Consumption of the meat of an infected camel has been reported to
cause plague in Libya in 1976 (1). The abstract of the paper is:
"In 1976, in a small, remote Libyan village, an apparently sick camel
was slaughtered and skinned, and the camel meat was distributed for
human comsumption. A few days later, 15 villagers suffered a severe
febrile illness. Of the 5 individuals who had participated in the
killing and dispensation of the camel, all were dead within 4 days.
When samples of serum from 9 of the remaining patients were examined,
7 were found to be positive for plague as determined by the passive
hemagglutination test. Another 6 persons became ill after killing 2
goats, and the serum of one goat contained antibodies to _Yersinia
pestis_. Because all of the remaining patients except one were
treated early enough, they recovered. These incidents confirm
previous reports that the camel and the goat are susceptible to
naturally occurring plague infection and have a significant role in
the dissemination of human plague."
Two more recent outbreaks in the Arab world have been reported in
2005. In Saudi Arabia (2), a cluster of 5 plague cases were reported
including 4 with severe pharyngitis and submandibular lymphadenitis.
These 4 case-patients had eaten raw camel liver. _Yersinia pestis_
was isolated from bone marrow of the camel and from jirds (_Meriones
libycus_) and fleas (_Xenopsylla cheopis_) captured at the camel
corral. In Jordon (3), a 1997 outbreak of plague was reported,
associated with cervical lymphadenopathy and fever, occurred in the
Jordanian village of Azraq ad-Druze, 50 km [31 miles] west of the
border with Saudi Arabia. The 12 cases who presented at hospital were
initially assumed to have tularaemia, and all were successfully
treated with gentamicin. But all 12 were found to have anti-_Y.
pestis_ IgM. 11 of the 12 patients reported that, 2-4 days before
their symptoms appeared, they had eaten the meat cut from the carcass
of the same camel, either raw (10 cases) or cooked (one case). All 12
patients were diagnosed as cases of pharyngeal plague (the 1st cases
of plague reported in Jordan for more than 80 years), caused by _Y.
pestis_ that most had acquired when they ate raw meat from a camel
that was infected with the pathogen.
The source of the cases of bubonic plague in northeastern Libya is
not reported in this posting but may be related to camels and camel
fleas.
1. Christie AB, Chen TH, Elberg SS. Plague in camels and goats: their
role in human epidemics. J Infect Dis 1980;141: 724-726.
2. Bin Saeed AA, Al-Hamdan NA, Fontaine RE: Plague from eating raw
camel liver. Emerg Infect Dis. 2005;11: 1456-1457.
3. Arbaji A, Kharabsheh S, Al-Azab S, et al: A 12-case outbreak of
pharyngeal plague following the consumption of camel meat, in
north-eastern Jordan. Ann Trop Med Parasitol. 2005;99: 789-793.
- Mod.LL]
[see also:
Plague, fatal - Algeria (04): NOT 20090206.0534
Plague, fatal - Algeria 20090119.0237
2003
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Plague - Algeria (Oran) (05) 20030710.1689
Plague - Algeria (Oran) (02): confirmed 20030624.1556
Plague, bubonic - Algeria (Oran) 20030622.1537]
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