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Pneumonic plague in Madagascar

NOV 01, 2017

Pneumonic plague in Madagascar

In the News recently is the ongoing outbreak of plague in Madagascar, which has so far claimed 102 lives. Since December 2016, there have been 1,297 reported cases, of which 846 (65%) have been of the pneumonic type (Source: UN Children’s Fund, 22/10/2017). The outbreak is yet to peak.

Madagascar has had endemic plague since the 1980s, with a few tens to hundreds of cases per year, mostly (>90%) of the bubonic type, spread by fleas and rats, affecting mainly local people with poor sanitation. As a TB doctor, working with some of the poorest and most remote people in the country, Jim has naturally had to prepare for the risk of plague on each of the expeditions he has led there.

What is different this year, is that the plague bacterium, Yersinia pestis, seems to have switched more to the pneumonic type, which is spread from person-to-person by close contact, e.g. when travelling on packed taxi-brousses. Pneumonic plague develops quickly after infection with symptoms of fever, chills and chest problems, often within 24 hours. It is nearly always fatal without any antibiotic treatment. Because it is so easily transmitted, it has now spread to several urban areas, including Antananarivo (a.k.a. Tana) and Toamasin (Tamatave). One foreigner has so far died.

Naturally, this is causing a degree of panic within the country, and public health teams and outside agencies are responding accordingly.

If you are travelling to Madagascar, Jim can advise you and provide you with some standby antibiotics to take in an emergency. Most travellers are at very low risk, if sensible precautions are taken.

If you would like to help the people of Madagascar directly, please send a donation via the following link to support the good work of Médicins Sans Frontières, who are helping to coordinate the response on the ground.

©Jim Bond, 26th Oct 2017

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