One Health: navigating plague in Madagascar amidst COVID-19.

BACKGROUND: Africa sees the surge of plague cases in recent decades, with hotspots in the Democratic Republic of Congo, Madagascar, and Peru. A rodent-borne scourge, the bacterial infection known as plague is transmitted to humans via the sneaky bites of fleas, caused by Yersinia pestis. Bubonic plague has a case fatality rate of 20.8% with treatment, but in places such as Madagascar the mortality rate can increase to 40-70% without treatment. MAIN TEXT: Tragedy strikes in the Ambohidratrimo district as three lives are claimed by the plague outbreak and three more fight for survival in the hospitals, including one man in critical condition, from the Ambohimiadana, Antsaharasty, and Ampanotokana communes, bringing the total plague victims in the area to a grim to five. Presently, the biggest concern is the potential plague spread among humans during the ongoing COVID-19 pandemic. Effective disease control can be achieved through training and empowering local leaders and healthcare providers in rural areas, implementing strategies to reduce human-rodent interactions, promoting water, sanitation and hygiene practices (WASH) practices, and carrying out robust vector, reservoir and pest control, diversified animal surveillance along with human surveillance should be done to more extensively to fill the lacunae of knowledge regarding the animal to human transmission. The lack of diagnostic laboratories equipped represents a major hurdle in the early detection of plague in rural areas. To effectively combat plague, these tests must be made more widely available. Additionally, raising awareness among the general population through various means such as campaigns, posters and social media about the signs, symptoms, prevention, and infection control during funerals would greatly decrease the number of cases. Furthermore, healthcare professionals should be trained on the latest methods of identifying cases, controlling infections and protecting themselves from the disease. CONCLUSIONS: Despite being endemic to Madagascar, the outbreak's pace is unparalleled, and it may spread to non-endemic areas. The utilization of a One Health strategy that encompasses various disciplines is crucial for minimizing catastrophe risk, antibiotic resistance, and outbreak readiness. Collaboration across sectors and proper planning ensures efficient and consistent communication, risk management, and credibility during disease outbreaks.

Pandemic realism as the indispensable political precondition for global disease eradication.

This article examines the politico-scientific mechanism, which leads nations to declare an epidemic or a pandemic finished, irrespective of the actual epidemiological situation at a given time. A historical comparison is made with the famous behavior of Emperor Justinian I (482-565 CE) during the plague pandemic named after him (part of the first plague pandemic). Finally, a reference to the importance of the multidisciplinary study of the history of medicine and the intersection between pandemics and wars is made.

Preliminary investigation and intervention of the suspected plague outbreak in Madunga, Babati District-Tanzania.

BACKGROUND: Rodents are known to be reservoirs of plague bacteria, Yesinia pestis in the sylvatic cycle. A preliminary investigation of the suspected plague outbreak was conducted in Madunga Ward, Babati District Council in Manyara Region December-2019-January 2020 Following reported two cases which were clinically suspected as showing plague disease symptoms. METHOD: The commensal and field rodents were live trapped using Sherman traps in Madunga Ward, where plague suspect cases were reported and, in the Nou-forest reserve areas at Madunga Ward, Babati District Council, to assess plague risk in the area. Fleas were collected inside the houses using light traps and on the rodents 'body after anaesthetizing the captured rodent to determine flea indices which are used to estimate the risk of plague transmission. Lung impression smears were made from sacrificed rodents to examine for possible bipolar stained Yersinia spp bacilli. RESULTS: A total of 86 rodents consisting of ten rodent species were captured and identified from the study sites. Nine forest rodent species were collected. Field/fallow rodent species were dominated by Mastomys natalensis. whereas domestic rodent species captured was Rattus rattus. Overall lung impression smear showed bipolar stain were 14 (16.28%) while House Flea Index (HFI) was 3.1 and Rodent Flea Index (RFI) was 1.8. CONCLUSION: The findings of this study have shown that, the presence of bipolar stained bacilli in lung impression smears of captured species of rodents indicates (not confirmed) possible circulation of Yesrsinia pests in rodents and the high flea indices in the area which included the most common flea species known to be plague vectors in Tanzania could have played transmission role in this suspected outbreak. The study recommends surveillance follow-up in the area and subject collected samples to the standard plague confirmatory diagnosis.

Pandemic Outbreaks and the Language of Violence: Discussing the Origins of the Black Death and COVID-19.

The outbreak of COVID-19 has brought renewed attention to past narratives of disease outbreaks. What do the Black Death and COVID-19 have in common? How we tell outbreak stories is shaped by political, cultural, social, and historical contexts. It is deeply rhetorical. The general public relies on experts (scientists, historians, and government officials) to provide credible information, but uncertainties during an outbreak can make it difficult to provide definitive answers quickly. Experts need to be conscious about the contexts in which their statements would be received. Regarding the Black Death, historians of medicine have relied heavily on a single medieval account of the outbreak, which confirmed their preconceptions about Mongol violence, allowing them to present the Black Death as an instance of biological warfare. Looking at other medieval accounts, however, makes clear that this narrative of Mongol biological warfare is false. Similarly, modern outbreak narratives also tend to use militarized language, which results in othering peoples and cultures where a disease might have originated. Given the contemporary political tensions between China and the United States, narratives about the origin of the SARS-CoV-2 virus and its transmission have led to a transnational infodemic of misinformation as well as discrimination and violence against people of Asian descent. In light of this long-running pattern, we argue for more interdisciplinary collaborations between the experts whose work is used to build outbreak narratives to adopt more critical rhetorical approaches in communicating with the public.

The impact of COVID-19 on clinical research for Neglected Tropical Diseases (NTDs): A case study of bubonic plague.

BACKGROUND: Among the many collaterals of the COVID-19 pandemic is the disruption of health services and vital clinical research. COVID-19 has magnified the challenges faced in research and threatens to slow research for urgently needed therapeutics for Neglected Tropical Diseases (NTDs) and diseases affecting the most vulnerable populations. Here we explore the impact of the pandemic on a clinical trial for plague therapeutics and strategies that have been considered to ensure research efforts continue. METHODS: To understand the impact of the COVID-19 pandemic on the trial accrual rate, we documented changes in patterns of all-cause consultations that took place before and during the pandemic at health centres in two districts of the Amoron'I Mania region of Madagascar where the trial is underway. We also considered trends in plague reporting and other external factors that may have contributed to slow recruitment. RESULTS: During the pandemic, we found a 27% decrease in consultations at the referral hospital, compared to an 11% increase at peripheral health centres, as well as an overall drop during the months of lockdown. We also found a nation-wide trend towards reduced number of reported plague cases. DISCUSSION: COVID-19 outbreaks are unlikely to dissipate in the near future. Declining NTD case numbers recorded during the pandemic period should not be viewed in isolation or taken as a marker of things to come. It is vitally important that researchers are prepared for a rebound in cases and, most importantly, that research continues to avoid NTDs becoming even more neglected.

Differential mortality of infectious disease in Italian polities: COVID-19, past plague epidemics, and currently endemic respiratory disease.

Coronavirus disease 2019 (COVID-19) has harshly impacted Italy since its arrival in February 2020. In particular, provinces in Italy's Central and Northern macroregions have dealt with disproportionately greater case prevalence and mortality rates than those in the South. In this paper, we compare the morbidity and mortality dynamics of 16th and 17th century Plague outbreaks with those of the ongoing COVID-19 pandemic across Italian regions. We also include data on infectious respiratory diseases which are presently endemic to Italy in order to analyze the regional differences between epidemic and endemic disease. A Growth Curve Analysis allowed for the estimation of time-related intercepts and slopes across the 16th and 17th centuries. Those statistical parameters were later incorporated as criterion variables in multiple General Linear Models. These statistical examinations determined that the Northern macroregion had a higher intercept than the Southern macroregion. This indicated that provinces located in Northern Italy had historically experienced higher plague mortalities than Southern polities. The analyses also revealed that this geographical differential in morbidity and mortality persists to this day, as the Northern macroregion has experienced a substantially higher COVID-19 mortality than the Southern macroregion. These results are consistent with previously published analyses. The only other stable and significant predictor of epidemic disease mortality was foreign urban potential, a measure of the degree of interconnectedness between 16th and 17th century Italian cities. Foreign urban potential was negatively associated with plague slope and positively associated with plague intercept, COVID-19 mortality, GDP per capita, and immigration per capita. Its substantial contribution in predicting both past and present outcomes provides a temporal continuity not seen in any other measure tested here. Overall, this study provides compelling evidence that temporally stable geographical factors, impacting both historical and current foreign pathogen spread above and beyond other hypothesized predictors, underlie the disproportionate impact COVID-19 has had throughout Central and Northern Italian provinces.

Lessons from the 1656 Neapolitan Plague: Something to learn for the current coronavirus Pandemic?

In the spring of 1656, an epidemic of bubonic plague suddenly fell on Naples, the capital of the Kingdom of the Two Sicilies. The epidemic had put a strain on the government authorities, forcing them to take sometimes drastic measures but, in most cases, scarcely decisive. The current health emergency caused by Covid-19 disease has many similarities with the epidemics of the past. Here we report the parallelism among plague and Covid-19 in several respects. Taking as a paradigm the plague epidemic of Naples of 1656, we can easily understand how history, showing us how past epidemics were managed and overcome, even with the intrinsic differences due to the limits of time and scientific progress, can still give us a useful lesson to face the present.

Pandemics and education: A historical review.

Major pandemics have tremendous effects on society. They precipitated the early decline of the Western Roman Empire and helped spread Christianity. There are countless such examples of infectious diseases altering the course of history. The impact of epidemics on education however is less well documented. This present historical account of the past 800 years looks specifically at how some aspects of education were shaped from the early medieval epidemics such as leprosy and the Black Plague to the Spanish Flu and COVID-19. Leprosy changed religious education, and the Black Plague may have contributed to the rise of medical schools, hospitals, public health education, and led to the implementation of lazarettos and the quarantine. The smallpox epidemic helped usher in public health education for immunization, while the 1918 Spanish Flu precipitated the rise of education by correspondence, and recently COVID-19 has catapulted remote digital learning to the forefront of higher education.

[From the Antonine Plague to the Cyprian Plague: Scopes and consequences of global plagues in the Roman Empire in the 3rd century AD.] / De la Peste Antonina a la Peste de Cipriano: Alcances y consecuencias de las pestes globales en el Imperio Romano en el siglo III d.C.

Between the 2nd and 3rd centuries the Roman Empire suffered two great plagues, the Antonine Plague, of which there is a bibliography, and the lesser known Plague of Cyprian. As an overview, both pandemics resemble the crisis that in 2020 the Coronavirus is generating in many aspects of human life. This article focuses on the impact that the Cyprian plague had in the context of the crisis of the third century, its mortality is estimated between 10-20% of the population in the affected places, finally its effects generated several of the necessary conditions for the transition from the ancient to the medieval world. It is about understanding how the cycle of plagues that went from the 2nd century to the 3rd century changed the appearance of the Roman world and what lessons history gives us 1700 years later.

First Prototype of the Infectious Diseases Seeker (IDS) Software for Prompt Identification of Infectious Diseases.

The rapid detection of ongoing outbreak - and the identification of causative pathogen - is pivotal for the early recognition of public health threats. The emergence and re-emergence of infectious diseases are linked to several determinants, both human factors - such as population density, travel, and trade - and ecological factors - like climate change and agricultural practices. Several technologies are available for the rapid molecular identification of pathogens [e.g. real-time polymerase chain reaction (PCR)], and together with on line monitoring tools of infectious disease activity and behaviour, they contribute to the surveillance system for infectious diseases. Web-based surveillance tools, infectious diseases modelling and epidemic intelligence methods represent crucial components for timely outbreak detection and rapid risk assessment. The study aims to integrate the current prevention and control system with a prediction tool for infectious diseases, based on regression analysis, to support decision makers, health care workers, and first responders to quickly and properly recognise an outbreak. This study has the intention to develop an infectious disease regressive prediction tool working with an off-line database built with specific epidemiological parameters of a set of infectious diseases of high consequences. The tool has been developed as a first prototype of a software solution called Infectious Diseases Seeker (IDS) and it had been established in two main steps, the database building stage and the software implementation stage (MATLAB® environment). The IDS has been tested with the epidemiological data of three outbreaks occurred recently: severe acute respiratory syndrome epidemic in China (2002-2003), plague outbreak in Madagascar (2017) and the Ebola virus disease outbreak in the Democratic Republic of Congo (2018). The outcomes are promising and they reveal that the software has been able to recognize and characterize these outbreaks. The future perspective about this software regards the developing of that tool as a useful and user-friendly predictive tool appropriate for first responders, health care workers, and public health decision makers to help them in predicting, assessing and contrasting outbreaks.

The Manchurian Plague and COVID-19: China, the United States, and the "Sick Man," Then and Now.

In this article, I explore the historical resonances between China's 1911 pneumonic plague and our current situation with COVID-19. At the turn of the 20th century, China was labeled "the Sick Man of the Far East": a once-powerful country that had become burdened by opium addiction, infectious disease, and an ineffective government. In 1911, this weakened China faced an outbreak of pneumonic plague in Manchuria that killed more than 60 000 people. After the 1911 plague, a revolutionized China radically restructured its approach to public health to eliminate the stigma of being "the Sick Man." Ironically, given the US mishandling of the COVID pandemic, observers in today's China are now calling the United States "the Sick Man of the West": a country burdened by opioid addiction, infectious disease, and an ineffective government. The historical significance of the phrase "Sick Man"-and its potential to now be associated with the United States-highlights the continued links between epidemic control and international status in a changing world. This historical comparison also reveals that plagues bring not only tragedy but also the opportunity for change.

A critical assessment of proposed outbreaks of plague and other epidemic diseases in Ancient Egypt.

The current coronavirus disease 2019 (COVID-19) pandemic has reminded us of past epidemics. Pharaonic Egypt has often been associated with epidemics and disasters through the 10 plagues in the Bible. The aim of this study was to examine which epidemics and serious diseases can be effectively proven for Ancient Egypt through mummies and historical source texts. The biblical plagues cannot be proven because there is no agreement on the dating of the Exodus, or the Exodus is a conglomeration of memories of different events. Other diseases such as malaria and schistosomiasis have been proven for Ancient Egypt, while polio and smallpox are still uncertain. There are indications of a bubonic disease from the time of the middle 18th Dynasty, but its exact nature cannot be determined from source texts or mummies, as they are too vague.