Team of disease ecologists documents person-to-person spread of antimicrobial-resistant plague
New strain of deadly disease caused by Yersinia pestis emerged in an
outbreak in rural Madagascar

Date:
August 13, 2021
Source:
Northern Arizona University
Summary:
A team of scientists recently published their findings from a
remarkable study involving antimicrobial resistant (AMR) plague.



FULL STORY ========================================================================== Although the world is focused on the COVID-19 pandemic, there are many
other dangerous pathogens still out there, like Yersinia pestis, which
causes plague -- the deadly disease that killed tens of millions of
people during the infamous Black Death in the 14th century. Although
plague has been largely eradicated in the developed world, it still
affects hundreds of people globally each year.


==========================================================================
When a human is infected with bubonic plague from a flea bite and it goes untreated, the infection can progress and spread to the lungs, resulting
in pneumonic plague. The most feared clinical form of plague, pneumonic
plague is typically lethal if not quickly treated, and infected patients
can transmit the disease to others via respiratory droplets. A team of scientists from Northern Arizona University's Pathogen and Microbiome Institute, led by professor Dave Wagner, recently published their findings
from a remarkable study involving antimicrobial resistant (AMR) plague.

Although pneumonic plague outbreaks are now extremely rare, scientists
consider plague to be a reemerging and neglected disease, particularly
in the East African island country of Madagascar, which reports the
majority of annual global cases. With no vaccine against it, preventing mortality from plague requires rapid diagnosis followed by treatment with antibiotics. An AMR strain of Y. pestis -- resistant to the antibiotic streptomycin, usually the first- line treatment for plague in Madagascar
-- was isolated from a pneumonic plague outbreak that occurred there in
2013, involving 22 cases, including three fatalities.

Wagner's team, including PMI senior research scientists Dawn Birdsell
and Nawarat Somprasong, PMI assistant director Amy Vogler, professor
Herbert Schweizer, associate professor Jason Sahl and senior research coordinator Carina Hall, conducted a study of this outbreak, together
with long-term research partners at the Institut Pasteur de Madagascar and scientists at the Institute Pasteur Paris and the Madagascar Ministry of
Public Health. The results of the study, "Transmission of antimicrobial resistant Yersinia pestis during a pneumonic plague outbreak," were
recently published in the journal Clinical Infectious Diseases.

"By characterizing the outbreak using epidemiology, clinical diagnostics
and DNA-fingerprinting approaches," Wagner said, "we determined --
for the first time -- that AMR strains of Y. pestis can be transmitted person-to-person. The AMR strain from this outbreak is resistant
to streptomycin due to a spontaneous point mutation, but is still
susceptible to many other antibiotics, including co-trimoxazole. Luckily,
the 19 cases that were treated all received co- trimoxazole in addition
to streptomycin, and all of them survived." "The point mutation, which
also is the source of streptomycin resistance in other bacterial species,
has occurred independently in Y. pestisat least three times and appears
to have no negative effect on the AMR strain, suggesting that it could potentially persist in nature via the natural rodent-flea transmission
cycle. However, AMR Y. pestis strains are exceedingly rare and the
mutation has not been observed again in Madagascar since this outbreak,"
he said.

========================================================================== Story Source: Materials provided by Northern_Arizona_University. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Voahangy Andrianaivoarimanana, David M Wagner, Dawn N Birdsell,
Birgit
Nikolay, Faniry Rakotoarimanana, Lovasoa N Randriantseheno,
Amy J Vogler, Jason W Sahl, Carina M Hall, Nawarat Somprasong,
Simon Cauchemez, Herbert P Schweizer, Harimahefa Razafimandimby,
Christophe Rogier, Minoarisoa Rajerison. Transmission of
Antimicrobial Resistant Yersinia pestis During a Pneumonic
Plague Outbreak. Clinical Infectious Diseases, 2021; DOI:
10.1093/cid/ciab606 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/08/210813100332.htm

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