A. SITUATION ANALYSIS
Description of the disaster
A plague outbreak in Madagascar raised concern in neighbouring countries. As of 12 October 2017, a total 684 cases (suspected, probable and confirmed) including 57 deaths (CFR 8.3%) had been reported from 35 out of 114 districts. Of these, 474 were clinically classified as pneumonic plague.
On 16 October 2017, Madagascar Ministry of Health (MoH) reported that caseload that was at 805 (confirmed and suspected) with 74 deaths.
While Madagascar is accustomed to seasonal bubonic plague outbreaks, the current was characterised by a combination of pneumonic and bubonic plague. Pneumonic plague, which counted 65% of the caseload, is transmitted from person to person and the fact that the majority of the cases occurred in urban areas made this outbreak a serious concern not only for Madagascar, but for the region.
Consequently, WHO classified the 2017 Plague outbreak in Madagascar as a grade 2 emergency, and WHO liaison officer expressed concern, considering Seychelles as a priority country, which needed emphasis on preparedness and stated that support can be provided. Indeed, one Seychellois passed away in Madagascar after contracting the disease during a basketball tournament there in the early week of October.
On 10 October 2017, the Seychelles Ministry of Health notified WHO of a probable case of pneumonic plague. The probable case was a 34-year-old man who had visited Madagascar and returned to Seychelles on 6 October 2017. He developed symptoms on 9 October 2017 and went to a local health centre. Based on a medical examination and reported history of recent travel to Madagascar, pneumonic plague infection was suspected and he was immediately referred to hospital where he was isolated and treated. A rapid diagnostic test (RDT) performed within the country on 11 October 2017 on a sputum sample was weakly positive. The specimen was sent to the WHO Collaborating Centre for Plague at the Institut Pasteur in Paris, France. Between 9 and 11 October 2017, eight of his contacts developed mild symptoms and were isolated and treated. Two other suspected cases, without any established epidemiological link to the probable case, were also identified, isolated and treated.
Laboratory results released by the Institut Pasteur in France on 17 October 2017 showed that all 10 specimens were negative for plague. All the suspected cases were soon after discharged after completing their course of treatment. At the time of the launch of this DREF operation, no plague cases had been confirmed in Seychelles.
Plague is an infectious disease caused by the bacteria Yersinia pestis, zoonotic bacteria, usually found in small mammals and their fleas. It is transmitted between animals through fleas. Humans can be infected through: the bite of infected vector fleas, unprotected contact with infectious bodily fluids or contaminated materials and the inhalation of respiratory droplets/small particles from a patient with pneumonic plague.
Emergency Plan of Action Final Report Seychelles: Preparedness for the Plague In October 2017, nine countries and overseas territories were identified as high risk for plague outbreak by virtue of having trade and travel links to Madagascar. These priority countries included Comoros, Ethiopia, Kenya, Mauritius, Mozambique, Reunion, Seychelles, South Africa, and Tanzania.
The major donors and partners of the DREF include the Red Cross Societies and governments of Australia, Austria, Belgium, Britain, Canada, Denmark, Finland, Ireland, Italy, Japan, Luxembourg, Monaco, the Netherlands, Norway, Spain, Sweden and the USA, as well as DG ECHO, the UK Department for International Development (DFID), AECID, the Medtronic and Zurich Foundations and other corporate and private donors. On behalf of the Red Cross Society of Seychelles (RRSS), the IFRC would like to extend its gratitude to all partners for their generous contributions.