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Madagascar faces a new plague epidemic 

Although the number of plague cases reported in the country has decreased since 2013, the most severe forms are increasing.

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Madagascar faces a new plague epidemic 

While last French case dates back to 1945, Madagascar faces its annual plague epidemic. This year, record of epidemic that has been affecting island of Madagascar for more than a month continues to worsen and rose on Wednesday, 4 October, to 30 deaths, according to latest figures published by Malagasy Ministry of Health. "We have recorded 194 suspected cases of plague, including 30 deaths in all Madagascar since August," said AFP a ministry official, Dr. Manitra Cristina.

The outbreak began after death of a 31-year-old man 50 kilometers north-west of capital Antananarivo. The epidemic, which began in August, has spread to "large urban areas, unlike previous epidemics," according to World Health Organization (WHO).

Between 23 August and 30 September, 73 cases of pulmonary plague were reported, including 17 deaths, and 58 cases of bubonic plague with 7 deaths. An additional case of sepsis was also reported and anor was not specified.

Very fast death

The bubonic form is contracted by bites of fleas infected with bacterium Yersinia pestis. The infected patient has swollen glands near bite, which is black (hence name Black Plague). If infection is taken early on antibiotics, death can be avoided. But if late care, patient is at risk of sepsis or migration of bacterium into lungs, resulting in rapid death (48-72 hours). The bubonic form is not transmitted from man to man, contrary to pulmonary version, transmitted by air, which proves fatal in almost 100% of cases in absence of very rapid care.

The Malagasy Ministry of Public Health has activated crisis cells in Antananarivo and Toamasina and all cases are treated free of charge. The government has also taken emergency measures to try to curb epidemic's progress. In particular, he banned public rallies in streets of Antananarivo until furr notice and set up controls at airport of capital. field investigations, contact tracing, monitoring and monitoring of all close contacts have also been strengned. The Institut Pasteur has for its part announced dispatch of a team from Paris to lend a hand to local authorities.

Serious cases on rise

Madagascar remains most affected country in world by this infectious disease, followed by Democratic Republic of Congo and Peru. In 2015, 275 cases had been identified, including 63 deaths. Although number of cases has decreased sharply between 2013 and 2016, from 675 cases of which 118 deaths to 62 cases including 26 deaths, severe forms (pulmonary plague) leading to death have increased. A rise that is explained, according to WHO, by "a deterioration of health system linked to socio-political crisis that has afflicted country in recent years."

According to WHO, risk of international spread of disease appears to be very low. For this reason, organization "does not recommend any restrictions on travel or trade with Madagascar". For travellers, risk of infection with Yersinia pestis is generally low. On or hand, those who go to rural areas of plague-endemic areas may be exposed to risk, especially if y are camping, hunting or in contact with rodents. WHO recommends that y avoid heavily populated areas as well as contact with dead animals, tissues or infectious materials, and close contact with patients with pulmonary plague. They are also advised to protect mselves against flea bites using repellents used for mosquitoes.

» For more information, see our pest data sheet


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