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Plague Spreads Rapidly Through Madagascar

Madagascar’s annual plague outbreak leaves the island with 57 deaths and 884 known cases to date. The common outbreak of plague in Madagascar  begins in September and ends in April, but this year plague season started early in August. The life threatening illness is known to be endemic, or common, on the plateau of Madagascar, but has spread to urban parts of the country as well, including its capital city, Antananarivo, and the port city of Toamasina.

There are three types of plague infections: bubonic, septicaemic and pneumonic. According to the World Health Organization (WHO), 474 of the known cases have been categorized as pneumonic plague,156 cases have been classified as the bubonic plague, and only one case has been classified as the septicaemic plague. 54 cases remain unclassified. The pneumonic plague is the most severe form of the plague bacteria (Yersinia Pestis), which is most commonly found on small rodents and fleas. Humans that fall victim to the disease are usually bitten by a rodent flea carrying the deadly bacteria,  have handled a sick animal, or are infected by another person. Being in the same room as an infected person can easily spread the disease. The disease spreads to the lungs and if left untreated the disease is always fatal. If infected, a person is put into quarantine and put on a rigorous antibiotic treatment.

The World Health Organization’s website provides the story of a 34 year-old man who contracted the plague while traveling to Madagascar from the East African country of Seychelles. The man developed symptoms of what is thought to be pneumonic plague on October 9th. After visiting medical professionals, he was put into isolation and given antibiotics. After he completes his treatment, he will be transported to Paris to confirm the diagnosis. The man is currently in stable condition. Unfortunately, 11 people close to the victim showed symptoms of the pneumonic plague and were placed in isolation for treatment. According to WHO, October 13th marked the last day of the screening of over 320 people that came in contact with the victim while in Madagascar. All people who came into contact with the victim were given a course of antibiotics as a precaution. Another 577 children and 63 teachers who had also come into contact with the man between the dates of October 9-11 were also given a round of antibiotics to ensure that the disease would not spread. The World Health Organization says that “contact tracing was done thoroughly”.

In terms of prevention and outreach, a Crisis Emergency Committee was established on October 10th. The group meets daily to coordinate surveillance, contact tracing, case management, isolation, and supplies. The Madagascan government has  financially supported committees enabling them to set up isolation tents, purchase medication and important supplies. The government has also made it possible for the committees to successfully trace potentially infected people and open up contact tracer training for anyone who wants to help.

The Madagascar Ministry of Health has implemented screenings at airports to ensure that the plague does not spread internationally.  There currently are not any travel restrictions to Madagascar, but travellers are encouraged to avoid highly populated areas and are to wear surgical masks while in populated areas.

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