Patterns of Human Plague in Uganda, 2008–2016

• Main Authors: Joseph D. Forrester, Titus Apangu, Kevin Griffith, Sarah Acayo, Brook Yockey, John Kaggwa, Kiersten J. Kugeler, Martin Schriefer, Christopher Sexton, C. Ben Beard, Gordian Candini, Janet Abaru, Bosco Candia, Jimmy Felix Okoth, Harriet Apio, Lawrence Nolex, Geoffrey Ezama, Robert Okello, Linda Atiku, Joseph Mpanga, Paul S. Mead
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2017-09-01
• Series: Emerging Infectious Diseases
• Subjects: plague; Yersinia pestis; bubonic plague; pneumonic plague; Africa; Uganda
• Online Access: https://wwwnc.cdc.gov/eid/article/23/9/17-0789_article
• ISSN: 1080-6040; 1080-6059

Plague is a highly virulent fleaborne zoonosis that occurs throughout many parts of the world; most suspected human cases are reported from resource-poor settings in sub-Saharan Africa. During 2008–2016, a combination of active surveillance and laboratory testing in the plague-endemic West Nile region of Uganda yielded 255 suspected human plague cases; approximately one third were laboratory confirmed by bacterial culture or serology. Although the mortality rate was 7% among suspected cases, it was 26% among persons with laboratory-confirmed plague. Reports of an unusual number of dead rats in a patient’s village around the time of illness onset was significantly associated with laboratory confirmation of plague. This descriptive summary of human plague in Uganda highlights the episodic nature of the disease, as well as the potential that, even in endemic areas, illnesses of other etiologies might be being mistaken for plague.