Madagascar: Further deadly plague cases reported in September /update 1

Event

According to health authorities, two new deadly cases of bubonic plague were reported on September 18 in Miarinarivo (center), taking the death toll to four since the beginning of the ongoing outbreak. In total, 16 cases of bubonic plague, including five confirmed, were reported between August 1 and September 20 nationwide. On September 20, the Health Ministry declared the outbreak under control; however, additional cases are likely to be reported through at least April 2019, the end of "plague season."

Context

Two other deadly cases were previously reported in mid-September in the towns of Fiadanana (north of the capital Antananarivo) and Ambalavao (center).

Between August and November 2017, at least 202 fatalities linked to a total of 2417 confirmed cases of pneumonic and bubonic plague were reported during a nationwide outbreak.

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 should take measures to protect themselves from insect bites (use insect repellents, wear long sleeved shirts and pants, etc.), 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.