Plague outbreak in Madagascar

Madagascar: WHO has officially been notified by the Ministry of Health of Madagascar of a plague outbreak in Madagascar, the first case of which was identified on the 31th of August as a male from Soamahatamana village, Tsiroanomandidy district who later died on the 3rd of September.

By the 16th of November, 119 cases of plague had been reporting, including 40 mortalities. The Organization confirmed that only 2% of these cases were of the pneumonic form.

16 districts of seven regions across Madagascar have reported plague cases. Antananarivo, the capital and largest has also been affected with 2 recorded cases of plague, including 1 death. Due to the city’s high population density and the weak healthcare system, there is now a serious risk of disease spread.

Public health response

The national task force has been activated to manage the outbreak. With support from partners – including WHO, the Pasteur Institute of Madagascar, the “Commune urbaine d’Antananarivo” and the Red Cross – the government of Madagascar has put in place effective strategies to control the outbreak. Thanks to financial assistance from the African Development Bank, a 200,000 US dollars response project has been developed. WHO is providing technical expertise and human resources support. Measures for the control and prevention of plague are being thoroughly implemented in the affected districts. Personal protective equipment, insecticides, spray materials and antibiotics have been made available in those areas.

Background

Plague is a bacterial disease caused by Yersinia pestis, which primarily affects wild rodents. It is spread from one rodent to another by fleas. Humans bitten by an infected flea usually develop a bubonic form of plague, which produces the characteristic plague bubo (a swelling of the lymph node). If the bacteria reach the lungs, the patient develops pneumonia (pneumonic plague), which is then transmissible from person to person through infected droplets spread by coughing. If diagnosed early, bubonic plague can be successfully treated with antibiotics. Pneumonic plague, on the other hand, is one of the most deadly infectious diseases; patients can die 24 hours after infection. The mortality rate depends on how soon treatment is started, but is always very high.