Plague Outbreak in Madagascar
On 4 November 2014, the Ministry of Health of Madagascar notified WHO of an outbreak of plague evolving in the country since 31 August 2014. Outbreaks of plague occur frequently and follow a seasonal pattern in Madagascar.
The first case was notified on 31 August 2014 in a child, from the district of Tsiroanomandidy. As of 16 November 2014, a total of 119 cases and 40 deaths are reported in the country. Only 2% of reported cases are of the pneumonic form of plague.
Plague is now reported in 16 districts of seven regions of Madagascar. In the capital, Antananarivo, two cases including one death have been reported from two densely populated neighbourhoods. The situation can easily worsen due to the high population density in the capital city.
A national task force has been activated to manage this outbreak. With the support of partners such as World Health Organization, Madagascar has developed active and effective strategies to control this outbreak. An urgent procurement process has been used to make antibiotics available in all affected areas for the management of cases. Prevention and control measures are being systematically implemented in affected areas.
WHO does not advise any travel or trade restrictions on Madagascar based on the current information available on this outbreak.
Travellers to Madascagar and other countries where plague occurs are advised to take precautions to reduce contact with fleas and potentially infected rodents and other wildlife in areas affected by plague. Use repellent if you think you could be exposed to rodent fleas during activities such as camping, hiking, or working outdoors in areas affected by plague. Products containing DEET can be applied to the skin as well as clothing and products containing permethrin can be applied to clothing (always follow instructions on the label) to prevent flea bites.