Skip to main content Accessibility help
×
Home

Outbreak of gastroenteritis caused by Yersinia pestis in Afghanistan

  • T. LESLIE (a1) (a2), C. A. WHITEHOUSE (a3), S. YINGST (a3), C. BALDWIN (a3), F. KAKAR (a4), J. MOFLEH (a4), A. S. HAMI (a1), L. MUSTAFA (a4), F. OMAR (a4), E. AYAZI (a4), C. ROSSI (a3), B. NOORMAL (a4), N. ZIAR (a4) and R. KAKAR (a5)...

Summary

Plague, which is most often caused by the bite of Yersinia pestis-infected fleas, is a rapidly progressing, serious disease that can be fatal without prompt antibiotic treatment. In late December 2007, an outbreak of acute gastroenteritis occurred in Nimroz Province of southern Afghanistan. Of the 83 probable cases of illness, 17 died (case fatality 20·5%). Being a case was associated with consumption or handling of camel meat (adjusted odds ratio 4·4, 95% confidence interval 2·2–8·8, P<0·001). Molecular testing of patient clinical samples and of tissue from the camel using PCR/electrospray ionization–mass spectrometry revealed DNA signatures consistent with Yersinia pestis. Confirmatory testing using real-time PCR and immunological seroconversion of one of the patients confirmed that the outbreak was caused by plague, with a rare gastrointestinal presentation. The study highlights the challenges of identifying infectious agents in low-resource settings; it is the first reported occurrence of plague in Afghanistan.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Outbreak of gastroenteritis caused by Yersinia pestis in Afghanistan
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Outbreak of gastroenteritis caused by Yersinia pestis in Afghanistan
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Outbreak of gastroenteritis caused by Yersinia pestis in Afghanistan
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: Dr T. Leslie, Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, LondonWC1E 7HT, UK. (Email: toby.leslie@lshtm.ac.uk)

References

Hide All
1.Prentice, MB, Rahalison, L. Plague. Lancet 2007; 369: 11961207.
2.Stenseth, NC, et al. Plague: past present and future. PLoS Medicine 2008; 5: e3
3.World Health Organisation. Human plague in 2000 and 2001. Weekly Epidemiological Record 2003; 78: 253260.
4.Worsham, PL, et al. Plague. In: Lenhart, MK, Lounsbury, DE, Martin, JW, Dembek, ZF, eds. Medical Aspects of Biological Warfare. Washington, DC: Borden Institute, 2007, pp. 91–119.
5.Arbaji, A, et al. A 12-case outbreak of pharyngeal plague following the consumption of camel meat, in north-eastern Jordan. Annals of Tropical Medicine and Parasitology 2005; 99: 789793.
6.Bin Saeed, AA, Al-Hamdan, NA, Fontaine, RE. Plague from eating raw camel liver. Emerging Infectious Diseases 2005; 11: 14561457.
7.Christie, AB, Chen, TH, Elberg, SS. Plague in camels and goats: their role in human epidemics. Journal of Infectious Diseases 1980; 141: 724726.
8.Stenseth, NC, et al. Plague: past, present, and future. PLoS Medicine 2008; 5: e3.
9.Wallace, MR, et al. Endemic infectious diseases of Afghanistan [Review]. Clinical Infectious Diseases 2002; 34 (Suppl. 5): S171–207.
10.Sirisanthana, T, Brown, AE. Anthrax of the gastrointestinal tract. Emerging Infectious Diseases 2002; 8: 649651.
11.Ecker, DJ, et al. Ibis T5000: a universal biosensor approach for microbiology. Nature Reviews Microbiology 2008; 6: 553558.
12.Christensen, DR, et al. Detection of biological threat agents by real-time PCR: comparison of assay performance on the R.A.P.I.D., the LightCycler, and the Smart Cycler platforms. Clinical Chemistry 2006; 52: 141145.
13.Duermeyer, W, Wielaard, F, van der Veen, J. A new principle for the detection of specific IgM antibodies applied in an ELISA for hepatitis A. Journal of Medical Virology 1979; 4: 2532.
14.Iacono-Connors, LC, et al. Enzyme-linked immunosorbent assay using a recombinant baculovirus-expressed Bacillus anthracis protective antigen (PA): measurement of human anti-PA antibodies. Clinical Diagnostic Laboratory Immunology 1994; 1: 7882.
15.Wernery, U, Kaaden, O-R. Infectious Diseases in Camelids, 2nd edn.Berlin: Blackwell Wissenschafts-Verlag, 2002.
16.Baldwin, CD, et al. Usefulness of multilocus polymerase chain reaction followed by electrospray ionization mass spectrometry to identify a diverse panel of bacterial isolates. Diagnostic Microbiololgy and Infectious Diseases 2009; 63: 403408.
17.Postinikova, E, et al. Identification of bacterial plant pathogens using multilocus polymerase chain reaction/electrospray ionization-mass spectrometry. Phytopathology 2008; 98: 11561164.
18.Eshoo, MW, et al. Rapid and high-throughput pan-Orthopoxvirus detection and identification using PCR and mass spectrometry. PLoS ONE 2009; 4: e6342.
19.Eshoo, MW, et al. Direct broad-range detection of alphaviruses in mosquito extracts. Virology 2007; 368: 286295.
20.Sampath, R, et al. Global surveillance of emerging Influenza virus genotypes by mass spectrometry. PLoS ONE 2007; 2: e489.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed