Table 1.

Emerging and reemerging bacterial diseases in Africa in 21st century

Bacteria	Implications for Africa	Targets for prevention	References
Rickettsia felis	•2002: Officially described •Before 2010: Only one case reported in Africa •2010: Prevalence of about 4% of R. felis in blood samples of febrile individuals without malaria in Senegal (9/204) and Kenya (6/163) •2013: Confirmation of role of R. felis in fever in Senegal •2015: First detection in blood samples of febrile individuals in Gabon, reaching a prevalence of 39.7% (23/58) in rural area of Fougamou	Vector-control measures	[8], [9], [10], [13]
Tropheryma whipplei	•2001: Officially described •2010: (a) Prevalence of about 6.4% (13/204) in blood samples of febrile individuals without malaria in Senegal; (b) Main detected cause of fever in Sine-Saloum area in Senegal, in August 2010 (prevalence of 58.5% [17/29] in febrile individuals in village of Dielmo and 69% [9/13] in those of Ndiop) •2016: First detection in a febrile patient in Gabon	Sanitation facilities	[22], [26], [56]
Yersinia pestis (plague)	•Since 2000: Main outbreaks: Recurrent annual human infections and outbreaks in Madagascar, DRC, Uganda, United Republic of Tanzania (2000) •DRC, Uganda, United Republic of Tanzania (2001) •DRC, Malawi, Mozambique, Uganda, United Republic of Tanzania (2002) •Algeria, DRC, Mozambique, Uganda (2003) •DRC (2005) •DRC (2006) •Madagascar (2017): One of worst outbreak in world in past half century, 202 deaths	Reduce risk of wildlife-to-human transmission	[29], http://www.who.int/csr/don/27-november-2017-plague-madagascar/en/
Vibrio cholera (cholera)	•Main outbreaks since 2000: •Madagascar, Somalia (2000) •South Africa (2000–2001) •Chad, Nigeria, Tanzania, West Africa (2001) •Burundi, Côte d’Ivoire, DRC, Liberia, Malawi, Niger (2002) •Mozambique (2002–2004): 17 265 cases, 102 deaths •Benin, Côte d’Ivoire, DRC, Liberia, Mali, South Africa, Uganda, Zambia (2003) •Cameroon, Chad, Zambia (2004) •Niger (2004–2005) •West Africa (2005) •Angola and Republic of South Sudan (2006) •West Africa (2008) •Zimbabwe (2008–2009): largest outbreak, 98 585 cases, 4000 deaths •Zimbabwe (2011) •Central Africa, DRC, Sierra Leone, Republic of the Congo (2012) •Republic of South Sudan (2014) •DRC (2015) •United Republic of Tanzania (2015–2018): 33 421 cases, 542 deaths •Kenya, Zambia (2017) •DRC, Mozambique, Somalia (2017–2018) •Algeria (2018): Since mid-August 2018, 41 confirmed cases, two deaths, last reported sporadic cases in 1996 in this country (data provided by Algerian health authorities)	Appropriate water and sanitation facilities Oral cholera vaccination (transient protection about 3–5 years) To be alert during conflicts or natural disasters	[32], [33], http://www.who.int/csr/don/archive/disease/cholera/en/

DRC, Democratic Republic of the Congo.