Plague outbreak in Madagascar and recent introduction in the Seychelles
Madagascar has been experiencing an outbreak of plague since 23 August 2017, and 560 cases and 57 deaths (case fatality rate 10.1%) have been reported as of 12 October 2017. Of these cases, 394 are pneumonic plague, 143 bubonic plague, one is a septicaemic plague and the clinical presentation is undetermined for 22 cases. Cases have been mainly reported in the capital Antananarivo and the port city of Toamasina on the east coast. In addition, sporadic cases of pneumonic plague without apparent epidemiological links to the initial chain of transmission have been reported in several regions across the country.
One travel-associated case in the Seychelles with a recent history of travel to Madagascar has been reported.
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 these preventive measures:
- Use of personal protection against fleabites. As Madagascar is a malaria endemic area, the use of mosquito repellents for malaria can protect against flea bites;
- Avoidance of direct contact with sick or dead animals;
- Avoidance of close contact with sick persons in particular with patients diagnosed with pneumonic plague or patients with symptoms consistent with pneumonic plague;
- Avoidance of crowded areas where cases of pneumonic plague have been recently reported;
- Contacting travel clinics before departure to get information about the current plague outbreak in Madagascar including preventive measures and symptoms of pneumonic plague;
- Seeking immediate medical care if compatible symptoms are developed.