Abstract
occurring in 1984). However, plague has made an astonishing comeback in the last decade. Methods: n/a. Results: After a silence of 50 years, an outbreak of bubonic plague suddenly occurred close to Oran in Algeria, in June 2003. Eighteen bubonic cases were identified, and Yersinia pestis was isolated from 6 patients. In July 2008, a new cluster was reported among nomads 300 km south of the first one. Four members of one family were affected and one died. The bacillus was isolated from one patient. No epidemiological association was identified between the two events. On June 2009, 25 years after the last occurrence in the country, Libya reported five confirmed cases of bubonic plague in the Tobruk area. Y. pestis was isolated from three patients. In all these cases, further local ecological investigations confirmed the existence of a natural focus The re-emergence of human plague in the region is not without international consequences. Two of the last concerned natural foci are close to an international port which raises the question of the potential exportation of infected rodents. Cross-border tensions, between ‘‘plague countries’’ and ‘‘plague-free countries’’ have been observed although the foci’s limits are unknown as any systematic ecological investigation and surveillance is lacking. Additionally, the potential weaponization of Y.pestis together with international political tensions feed a recurrent interest in plague in North Africa. False rumors of alleged military laboratory accidents or terrorist acts are routinely mentioned, although events could be first explained by the natural history of the disease. Conclusion: In this context, and although the number of human cases has been very limited so far, the first priorities are to establish appropriate ecological surveillance and agree on a common plague control strategy for the region.
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