Yersinia pestis, first discovered in 1894 by Alexandre Yersin (a bacteriologist from the Pasteur Institute) while a plague occurred in Hong Kong, still continues to take lives in the world. In northeastern China and Mongolia, marmots are still a reservoir for plague and the recently last cases (bubonic plague) were reported in 2020 [https://www.bbc.com/pidgin/tori-53312263].
In other parts of the world, such as Madagascar, Ituri (DRC) and Peru, people experienced regularly plaque epidemics. Three clinical forms of human plague exist: bubonic, pneumonic, and septicemic. The bubonic form of plague is usually by fleas from infected rats to human but is not transmitted from human to human whereas the pneumonic form is through the inhalation of contaminated aerosol droplets.
The pneumonic plague can cause devastating consequences resulting in many casualties and if antibiotics are not administered rapidly after the initial symptoms, death is inevitable.
Between August 1st and November 26th, 2017, a total of 2414 clinically suspected plague cases were reported to the Central Laboratory for Plague (CLP) at the Institut Pasteur de Madagascar, including 1878 (78%) pulmonary plague (PP), 395 (16%) bubonic plague (BP), one (< 1%) septicemia and 140 (6%) cases with unspecified clinical form.
During this epidemic, Prof. COLLARD’s group isolated K. pneumoniae strains from some of clinically suspected plague patients during the plague outbreak in Madagascar in 2017 and characterized them. The patients were finally were negative for Yersinia pestis in culture.
The results demonstrated that a community-acquired pneumonia caused by K. pneumoniae isolates in patients suspected of plague was ongoing concomitantly to the plague epidemic and that bed‐side differential diagnosis is important while dealing with an epidemic. Moreover, some patients were treated by antibiotics for which the K. pneumoniae isolates were resistant.
Link of the article: https://pubmed.ncbi.nlm.nih.gov/35477743/
Contact
Jean-Marc COLLARD
Institut Pasteur of Shanghai, Chinese Academy of Sciences
E-mail: jean-marc.collard@ips.ac.cn
