Madagascar hit by deadly plague outbreak

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Following the outbreak of a deadly plague of both the pneumonic and bubonic variables in Madagascar, the World Health Organisation (WHO) has scaled up its response to stem the rate of infection, which has already affected over one hundred people and killed twenty-one within the last few weeks.

Among the fatalities was a Seychellois national, who was killed by pneumonic plague on 27 September. The basketball coach was on tour with his team in Madagascar when he was initially infected. Madagascan authorities are tracking people with whom he may recently have come into contact. Once identified, they will be given antibiotics as a precautionary measure.

The incident brings the death count to 21 since the outbreak was identified in late August; at least 114 people have been infected.

“WHO is concerned that plague could spread further because it is already present in several cities and this is the start of the epidemic season, which usually runs from September to April,” said Dr. Charlotte Ndiaye, WHO Representative in Madagascar.

“Our teams are on the ground in Madagascar providing technical guidance, conducting assessments, supporting disease surveillance, and engaging with communities,” she added. “We are doing everything we can to support the Government’s efforts, including by coordinating health actors.”

Further deployments of WHO staff and response partners in the Global Outbreak Alert and Response Network (GOARN) are underway, as well as increased supplies of antibiotics, personal protective equipment and other supplies.

WHO has released US$300 000 in emergency funds, as well as critical medical supplies, to quickly scale up operational efforts, and is appealing for US$1.5 million to support the response.

Plague is endemic to Madagascar, where around 400 cases of – mostly bubonic – plague are reported annually. Contrary to past outbreaks, this one is affecting large urban areas, which increases the risk of transmission. The number of cases identified thus far is higher than expected for this time of year.

Bubonic plague is spread by infected rats via flea bite, pneumonic by person-to-person transmission. The current outbreak includes both forms of plague. Nearly half of the cases identified so far are of pneumonic plague.

Plague is a disease of poverty. It thrives in places with poor sanitary conditions and inadequate health services. It can kill quickly if left untreated, but can also be cured by common antibiotics if delivered early.

The last reported outbreak in December 2016 was mainly bubonic plague occurring in a remote area.