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Madagascar: Plague Outbreak - Sep 2018

Status
Alert
Countries
Madagascar
Disaster types
Epidemic

On 19 August 2018, one suspected case of bubonic plague was reported in Ankazobe, Analamanga region. Subsequently, suspected pneumonic and bubonic cases have been reported in endemic and non-endemic areas of Madagascar. From 19 August to 20 September 2018, 15 cases including 5 deaths have been reported from 7 out of the 114 districts of the country in 5 regions. (WHO, 21 Sep 2018)

Early action is urgently required to avert a greater loss of life due to the plague outbreak ahead of an expected seasonal peak between November 2018 to March 2019. The timing also coincides with a Presidential elections period of October-December which will significantly increases the risk of transmission due to daily meetings of large crowds in all major cities in the country. A number of pneumonic cases have already been recorded in several districts close to the Capital and Pneumonic plague is highly transmissible (person-to-person) and can quickly cause death in the absence of treatment. Since 19 August the cumulative number of confirmed and suspected cases in the country is higher than the average and the maximum of 2012-2016. From August to 05 November 2018, a total of 106 cases of plague have been reported, in 23 out of 114 districts in the country; out of which, 36 are confirmed in 12 districts and 8 regions. To date, 9 deaths (case fatality rate 9.4%) have been registered, among which 6 cases were pneumonic and 4 of bubonic form. It is important to note that all of these deaths occurred in the community, highlighting weaknesses in the early warning system and low community awareness, both of which increase the risk of the outbreak spreading.. (OCHA, 13 Nov 2018)

Due to the need to continue post-epidemic and prevention activities, the IFRC response operation has been extended the first time over 15 months until 31 December 2018 and will be extended over 19 months to cover all period of plague season until the end of April 2019 considered as the end of the plague season. From 19 august to 26 November, 124 cases of plague have been recorded with 91 bubonic form (73.4 %), 31 pulmonary form (25%), 1 septicaemia case and one unspecified. A quarter of the cases a pulmonary originated from the plague form which can be transmitted from human to human and causes an outbreak as it happens last year. (IFRC, 7 Dec 2018)