Madagascar: Plague death toll rises to 195 /update 11

Event

World Health Organization (WHO) officials reported on Tuesday, November 21, that the number of reported cases of plague spiked in recent days. As of November 21, at least 195 people have died from pneumonic plague since the beginning of the current outbreak in August and 2267 cases of the disease have been confirmed. Despite the recent spike in cases, health officials said that the trend of new cases is still declining due to effective deployment of containment measures. However, officials still expect cases to be reported through the end of plague season in April 2018.

Containment measures will likely remain in place through April, including checkpoints on roads leading to the remaining affected areas to screen for potential cases of the illness. While schools reopened throughout the country on November 6, universities remain closed until further notice and a ban on public gatherings and meetings is still in effect. Individuals should allow time for health screenings at airports in Madagascar, and anticipate entry screening at airports in neighboring countries including Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania.

Context

Plague is a bacterial infection that typically affects rodents and is most often transmitted from rodents to other animals and humans via flea bites. Bubonic plague is the most common form of the disease, characterized by swollen lymph nodes; it is fatal in 30 to 60 percent of cases. Pneumonic plague occurs when the bacteria infects the lungs; symptoms include fever, headache, weakness, pneumonia, chest pain, shortness of breath, cough, and sometimes bloody or watery mucous. It is the most virulent form of the disease and can be spread from person to person. Without prompt and effective treatment, pneumonic plague is always fatal. Plague can be treated with antibiotics.

Advice

Individuals in Madagascar are advised to take measures to protect themselves from insect bites (use insect repellents, wear long sleeved shirts and pants, etc.), to maintain strict standards of sanitation (cleanliness to discourage presence of rodents, elimination of rodent habitats outdoors - e.g. brush, rock piles, pet food, etc.), use flea control products on all pets, and avoid contact with potentially infected persons. Anyone presenting with the above symptoms is advised to seek immediate medical attention.