Madagascar - Plague outbreak 2017-18

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Epidemic-Plague re-emerges

12.09.2017 | 8:36 News, alaune, Social0

Plague suspicions have been recorded in Toamasina, Moramanga and Antananarivo. Five deaths are recorded.

Around 17 pm yesterday, the van of the Municipal Bureau of Health (BMH) from the urban commune of Antananarivo, leaving the morgue of a hospital of Antananarivo city, with pine coffin on his bucket. She went towards the common grave of the cemetery of Anjanahary to bury a woman of forty, suspected to have died from pneumonic plague, according to a source within the (BMH). She would have died in the service of respiratory diseases of the hospital after being admitted on Sunday, according to concordant sources.

This victim had caught the disease by having a holiday in the east of the Big Island. "She was staying with her family in Toamasina, when four of them, including the husband and wife, died suddenly. It was suspected plague, "reported a relative who wanted to remain anonymous.

The eastern part is however not a plague area. We fear the connection between those deaths and that of a person who would come Moramanga and was traveling in Toamasina. Sources reveal that the latter would have joined Toamasina by bush taxi, starting from Moramanga and lost way of life, following a suspected pneumonic plague outbreak. It would have contaminated a young man sitting next to him in the public transport. The latter would also died.

Asked about these facts, the responsible service of the fight against the plague in the Ministry of Public Health at the hospital, preferred to remain silent. It is the same to the director of health surveillance and epidemiological surveillance of the Ministry. We do know he is on a mission to Toamasina now.

Five deaths

Another source in the ministry who would urge everyone to take precautions against these suspected cases of plague, revealed the existence of five suspicious deaths and ten patients since the beginning of the plague season. They were listed in Toamasina, Moramanga and Miarinarivo excluding that recorded in Antananarivo. She also stressed that members of the family of the deceased in Toamasina would already gone home, Mahajanga and Voh?mar.

There would not, however, the risk of disease transmission on people who have been in contact with the victim. The team of the Ministry of Public Health and of the BMH have been rushed to the hospital to distribute plague prevention drugs to his family and relatives and the hospital staff. They have also conducted a service disinfection operation where the deceased was admitted and the mortuary. Despite this, consulting a doctor is highly recommended in case of suspicious symptoms, namely high fever, painful glands, cough with bloody sputum. Bush fires are to be avoided and the sanitation of the neighborhoods are indicated, to prevent the rats from riding in the village.

Miangaly Ralitera


http://www.lexpressmada.com/blog/actualites/epidemie-la-peste-refait-surface/

 

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Five deaths due to plague in Madagascar

In a slum of Madagascar, the return of the rainy season also marks the return of the proliferation of rats..

? RFI / Sarah T?taud
By RFI Published on 14-09-2017 Modified on 14-09-2017 at 11:53

Five deaths of pulmonary plague have been confirmed by the Ministry of Health, including one in the capital. They occurred between 28 August and 11 September. In a press release, "the Ministry of Public Health calls the population to vigilance against proliferation of rats and flea proliferation. It recommends environmental sanitation and the fight against bush fires "which favors the arrival of rats in the villages.

The first death occurred on August 28th. A man from Ankazobe, a district very exposed to the plague, three hours' drive north of the capital, went by bush taxi to Toamasina on the east coast. He died on the road in the town of Moramanga. In the taxi-bush, the traveler contaminated two of his neighbors. One died on his arrival at Toamasina, the other on the following day. Either less than 24 hours after being infected.

Two other women, from the same family as the victims of Toamasina, died, one in Antananarivo, the other in the south of the capital in another taxi-bush. Dr. Manitra Rakotoarivony, Director of Health Promotion, said all infested taxi-brush passengers were found and treated for plague. Their homes and taxi-bushes have been disinfested. In Toamasina, pharmacies were stormed by a panicking crowd.

The ministry discourages self-medication that could lead to drug resistance and recommends that people go to the basic health centers. Indeed, all the people who have been in contact with the sick will be treated free of charge. To date, 22 suspect cases have been treated and 17 are currently in good health.

The Ministry also recommends that the Malagasy population be vigilant in case of clinical signs, ie high fevers, as well as the appearance of painful buboes or a strong cough. Other symptoms such as chest pain and bloody sputum are also to be monitored. Pulmonary or bubonic plague is a highly contagious virus caused by rat fleas and can cause death in less than 24 hours (for pulmonary plague) or within days (for bubonic plague). Each year, plague causes between 60 and 70 deaths.


http://www.rfi.fr/afrique/20170914-cinq-deces-dus-peste-pulmonaire-madagascar

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Rumor of plague in Antanimora - General panic in court Anosy

14.09.2017 | 8:35 News, alaune, Politics1

The rumor that the plague would have resulted in deaths of inmates Antanimora almost paralyze the Anosy court yesterday. A denial of the prison doctor was necessary to reassure the staff.
...
In a press release yesterday, the Ministry of Public Health said that "we are currently in the plague season in Madagascar."
...
The ministerial department added that "suspected cases of pulmonary plague have been reported in the Vakinankaratra, Analamanga, Alaotra-Mangoro, Antsinanana, Sava and Boeny regions ... Suspicious cases are under control and investigations are ongoing". If the Ministry of Health, trying to reassure the population, alarmist publications flooding, however, social networks, since Tuesday.

Accounts some of which are, at first, doubtful affirm the existence of death from the plague in several districts of the capital. The information published on Facebook, are, however, all denied by the health authorities. For many, however, the Ministry of Health seems to have been slow to respond officially to the public and explain what it really was.

No alarm given by the press it is likely that the existence of risks due to "the plague season," would never have been made public
...
Because of the panic that death rumor caused by the plague in Antanimora prison has caused the prosecutor, responded by "denouncing" the account that posted the information on Facebook, with management of fight against cybercrime with the Ministry of public Security yesterday.
...

http://www.lexpressmada.com/blog/ac...ntanimora-panique generale au tribunal anosy/

 

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Epidemic - Pulmonary plague suspected in Manjakaray

21.09.2017 | 8:36 News,

The plague epidemic would continue to cause casualties in Antananarivo. A suspect case was reported in the city yesterday.

A man in his thirties, living in the Manjakaray district, was tested positive to the rapid diagnostic test (RDT) of pneumonic plague, performed Ambohimiandra yesterday. "He has a high fever, coughing sputum streaked with blood. Worried, he consulted a doctor free. This was referred to Ambohimiandra where the test was done, "informs a matching source.

It would, however, expect the results of the scan sent to the Pasteur Institute of Madagascar (IPM), to confirm the case. Meanwhile, the patient would follow treatments in Ambohimiandra, support center plague. Four other people were also treated in this hospital right now. They are relatives of patients of pneumonic plague in Toamasina and Antananarivo that died on September 11.
Those who have contaminated this suspected case remain still unknown. It is not known if it is untreated bubonic or pulmonary plague transmitted by another patient. Asked about this case, the Ministry of Public Health has confirmed nothing. "Only the Health Watch and Epidemiological Surveillance (DVSSE) will be able to provide official statistics," said Dr. Manitra Rakotoarivony, Director of Health Promotion.

The active search for people in contact with the new suspected case have already been initiated by the team of the Ministry of Public Health. They would have benefited from "chemoprophylaxis" drugs, to prevent the spread of the disease.

...

Miangaly Ralitera

http://www.lexpressmada.com/blog/act...-a-manjakaray/

 

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Antananarivo - Rise in suspected cases of plague

22.09.2017 | 8:35 pm News, Social0

The number of cases of pulmonary plague is increasing in Antananarivo. The Ministry of Public Health is stepping up its efforts to prevent the spread of the disease.

The anti-plague of Ambohimiandra hospital (CHAPA) hosted its sixth sick yesterday to 14 hours. Its rapid diagnostic test (RDT) to the pneumonic plague was positive. Wednesday in the early evening, another case was admitted. Shortly before this, the young man living in Manjakaray also joined this hospital bed. In total, therefore, they are six to undergo treatment in this hospital right now. Still considered as suspected cases of pneumonic plague, their sputum analysis were sent to the Pasteur Institute of Madagascar (IPM) for confirmation.

These patients live all the agglomeration of Antananarivo, namely Manjakaray, Andraisoro, Ankaraobato, Soavimasoandro and Ambohimanarina. The mode of disease contamination remains an enigma to some of the cases, while for others, it was transmitted by victims of pulmonary plague that killed five people in Toamasina and Antananarivo in early .

At this rate, the CHAPA carrying capacity, limited to eight patients, will soon be exceeded. The Ministry of Health has therefore requested the National Bureau of Risk Management and Disaster (BNGRC) to install the faster a tent in the grounds of the hospital, if other cases arise. The guard team, who works hard to support the sick, will also be strengthened. The doctors reassured that the plague is easily treated. "If the case is diagnosed and treated in time, there is no risk of death. Patients are already out of this establishment, healthy, "said a doctor who strongly seeks medical consultation in case of high fever, fatigue, cough, sputum streaked with blood or lymph nodes.

Ten deaths

Since the end of August until 17 September, sixty cases of plague, throughout Madagascar, were confirmed by the IPM, according to Dr. Manitra Rakotoarivony, director of Health Promotion. "Fifty have been treated and are alive. Ten have succumbed, "he informed, after the daily meeting of ministry staff on the plague season yesterday. He did not specify the number of victims of pneumonic plague. The Minister of Health, Professor Mamy Lalatiana Andriamanarivo, said Monday that the victims of this epidemic of pulmonary plague amounted to thirty and five died.

A plague treatment specialist informs that pneumonic plague transmitted from human to human is the most binding form of this disease. He noted, however, that despite the existence of these suspected cases, it is strictly "prohibited to consume Cotrim, unless medical advice." The port cover mouth would not, either, said. "To avoid the contamination of the disease, sanitation is highly recommended, avoid throwing food or cooked rice anywhere, it attracts rats. Plague is a disease of rats. It will also avoid spitting everywhere, "he advises.

Since Wednesday, volunteers and the Ministry of Health teams have conducted campaigns disinfection and disinfestation in neighborhoods of suspected cases and in hazardous locations. The active search for people in contact with the sick and the dead is also underway for the contact chemoprophylaxis.

Miangaly Ralitera

http://www.lexpressmada.com/blog/actualites/antananarivo-hausse-des-cas-suspects-de-peste/

 

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Soavimasoandro - Suspected death of a child's plague

26.09.2017 | 8:35 pm News, Social0

Antananarivo-city records its second suspected death of pulmonary plague. Emergency meetings were held in Ambohidahy yesterday.

The plague epidemic of suspicion shook the capital. Yet another victim was listed since the appearance of the disease in Antananarivo on September 11. Sunday is a 6 year old girl, living in Soavimasoandro, who suddenly died after being sick the night before, the report said the Ministry of Public Health.

"Her collection, analyzed on a rapid diagnostic test, said she is a carrier of pneumonic plague bacterium. We await the results of analysis of the Pasteur Institute of Madagascar (IPM), before they can confirm, "said a source at the Ministry yesterday.
The girl and her family were returning from a trip to Fianarantsoa, ​​where they would have seen a reversal of the dead. The first hypothesis of contamination focus on this event. "Often plague victims are buried in their family tomb, if they should be put in a mass grave to prevent the spread of the disease. If such a case arises, the tomb of the opening is banned for seven years, "added the source. We must not forget, however, that a suspected case of pneumonic plague was already listed in the same area on September 15, and as recently as last week, another suspected case in the same district, specifically Manjakaray, was admitted to the anti-plague hospital in Ambohimiandra (CHAPA) for processing.

Contamination

The management of this girl has been slow. His family was the first took her to a doctor free. The latter was sent to a children's hospital. Suspecting pneumonic plague, officials of the latter was transferred to CHAPA.
If this case is confirmed, all the people in contact with her family, the passengers of the bush taxi on board which she traveled to reach Antananarivo, doctors who treated all at risk of catching in turn, disease. The Ministry of Public Health has already launched active research of all these people, for a "chemoprophylaxis of contact".

In addition, emergency meetings between the Ministry and the technical and financial partners on the one hand and the Ministry and the authorities of the District Heads of the Boroughs of the City of Antananarivo on the other hand Ambohidahy yesterday.

"The objective is to strengthen the fight against the disease, in particular, awareness on the sanitation of the city very unhealthy, which can promote the spread of the disease," says one source. Campaigns disinfection, rodent and pest continues in town.

Miangaly Ralitera

http://www.lexpressmada.com/blog/ac...es-suspect-de-peste-pulmonaire-dune-fillette/

 

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Plague outbreak - Fifteen deaths on nearly one hundred suspected patients

27.09.2017 | 8:34 News, alaune, Social0

The record of the plague epidemic is increasing. It touched seventeen districts in two months.

Balance scary. Nearly two months after the onset of the first case of plague in this plague season, the listed victims graze hundred. Ninety three suspected plague patients registered between 1 August and 25 September, fifteen of them have died, according to the latest report from the Ministry of Public Health, announced at the meeting of daily crisis cell Ambohidahy yesterday .

Seventeen districts are now affected by the epidemic, particularly those of the central highlands. This is, among others, of Antananarivo city, of Avaradrano, of Atsimondrano, of Andramasina, Ankazobe, Moramanga, Ankazobe, Ambohidratrimo, Tsiroanomandidy, Miarinarivo, Faratsiho, of Arivonimamo and Maevatanana. The disease also spread in non plague areas, namely Voh?mar and Toamasina, where imported cases were reported at the beginning of the month. It's a sick with plague from Ankazobe, traveling aboard a bush taxi joining Toamasina, in late August, which caused the epidemic of pneumonic plague in Toamasina and Antananarivo to Voh?mar city. Cases of bubonic plague are reported in other districts.

Nearly doubled

In Antananarivo, four patients suspected of pulmonary plague still follow treatments anti-plague hospital in Ambohimiandra (CHAPA), until yesterday. Two others would be returned home, restored and without risk of contamination.

The Minister of Public Health, Professor Mamy Lalatiana Andriamanarivo, reassures us that the epidemic is under control, new cases appear almost every day if we only talk about the death of a girl in Soavimasoandro on Sunday following pulmonary suspicion. There were also patients admitted to CHAPA last week. Following this, the figure has almost doubled in the space of a few days. Last week, there were still sixty cases confirmed by the Institut Pasteur of Madagascar (IPM).

We are only at the beginning of the plague season right now. It is planned to be completed in April 2018. Until then, this epidemic will be hundreds of victims, if serious measures are not taken. Everyone has to make his own, especially in terms of sanitation, to prevent the rise of rats at the village level. Plague is a disease of rats that is transmitted accidentally to man. Pneumonic plague occurs by sudden high fever, fatigue, cough blood-streaked. The appearance of painful glands is the symptom of bubonic plague. This disease presents no danger, if treated in time.

Miangaly Ralitera

http://www.lexpressmada.com/blog/ac...inze-deces-sur-pres-de-cent-malades-suspects/

 

[Shiloh]

Source: https://medicalxpress.com/news/2017-09-plague-madagascar.html

Plague kills 19 in Madagascar
September 28, 2017

An outbreak of plague in Madagascar has killed 19 people and may have infected 85 others in just two months, the Indian Ocean island nation's health minister said Thursday.

Plague, a highly infectious disease carried by small mammals like rats, killed millions of people across the world in the past but has been largely wiped out.

"We have recorded 104 suspected cases of plague across Madagascar of which 19 have died," Health Minister Mamy Lalatiana Andriamanarivo told journalists...

 

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Epidemic of plague - A Comorian child admitted to Ambohimiandra

29.09.2017 | 8:35 pm News, Social0

The suspicion of plague touched a stranger in Antananarivo. The victim, a Comorian child, is treated at the anti-plague hospital in Ambohimiandra (CHAPA).

The anti-plague hospital in Ambohimiandra (CHAPA) has its umpteenth patient. A child Comoros was admitted to this hospital early yesterday morning for a rapid diagnostic test (RDT) positive for plague. The information comes from the Ministry of Health, very late in the evening. "At the moment, we have no details to share with you. We simply know that he is alive, "says Dr. Hery Andrianjato, Director of the Partnership and Acting Director of Health Promotion in the Ministry of Public Health, reached by phone. He, however, clarified that this child was hospitalized in a hospital mother and child, before being transferred to Ambohimiandra.

Parents with children hospitalized at this facility are in panic. "Our children may be contaminated too," they worry. But the ministry and its technical and financial partners are reassuring in this regard. "The patients suspected of plague, admitted to a hospital are isolated. And the place is disinfected, there is no risk of contamination, "says one at the Hotel Colbert in Antaninarenina yesterday during a technical discussion on the plague.

Nineteen deaths

A new living suspected case was also listed in Ankazobe yesterday. This leads to one hundred and nine, the number of suspected cases of plague throughout Madagascar, until last night. Nineteen of them died.

The Minister of Public Health, Professor Mamy Lalatiana Andriamanarivo, acknowledged that it was difficult to control 100% of this disease, "as long as rats continue to circulate". All are invited to mobilize for sanitation, rodent control, disinfection, the fight against bush fires. But the question that intrigues everyone is: how to protect themselves from the plague that plagues Antananarivo, currently? According to the technicians, the air does not carry the plague bacillus. It would be transmitted in direct contact with the victim. Furthermore, sunny, the bacillus would not survive.
"How can we be assured that the person sitting on the same seat us in a public transport vehicle in is not infected? "Ask others. The specialists of the plague first emphasize that plague person may cough with sputum streaked with blood, have a high fever and chest pain present. In this case, the port cover mouth is recommended, both for the patient and for the healthy person close to him. If these symptoms occur, consulting a doctor is mandatory. "The disease is being treated if it is treated on time," says Dr. Hery Andrianjato.

For better support, reinforcements capacity of health personnel, public and private, are made at the hotel Panorama Andrainarivo currently. "It's a kind of refresher doctors on prevention, and the manifestation of the disease," said a ministry official.

Miangaly Ralitera


http://www.lexpressmada.com/blog/ac...ste-un-enfant-comorien-admis-a-ambohimiandra/

 

[Gert van der Hoek]

Plague in Madagascar (28 September 2017)

Key points:

• Pneumonic plague has been detected in several cities in Madagascar.
• It is a form of plague that is highly transmissible (person-to-person) and quickly causes death without treatment.
• WHO is concerned that the outbreak may spread because it is already present in several cities and this is just the start of the plague epidemic season, which usually runs from September to April.

PEOPLE AFFECTED

• 104 cases of which 52 pneumonic plague (23 Aug-28 Sept)
• 20 deaths - 19.23% case fatality rate (CFR) of the current outbreak

Key facts - PLAGUE

• Plague is caused by the bacteria Yersinia pestis, a zoonotic bacteria, usually found in small mammals and their fleas.
• Plague can kill quickly if left untreated, but common antibiotics can effectively cure it if they are delivered early.
• People infected with plague usually develop "flu-like" symptoms after an incubation period of 1-7 days.
• There are 2 main clinical forms of plague infection: bubonic and pneumonic.
• Bubonic plague is the most common form and is spread by rats, pneumonic by person-to-person transmission.
• The current outbreak combines both forms of plague.
• Plague is endemic to Madagascar, where around 400 cases of – mostly bubonic – plague are reported annually
• Madagascar’s last severe plague outbreak in December 2016 affected 68 people and caused 27 deaths.

 

[Shiloh]

Source: http://www.who.int/csr/don/29-september-2017-plague-madagascar/en/

[h=1]Plague ? Madagascar[/h] Disease outbreak news
29 September 2017

On 23 August 2017, a 31-year-old male from Tamatave, visiting Ankazobe District in central highlands, developed malaria-like symptoms. On 27 August, he developed respiratory symptoms during his journey in a shared public taxi from Ankazobe District to Tamatave (via Antananarivo). His condition worsened and he died. His body was prepared for a funeral at the nearest hospital, Moramanga District Hospital, without safety procedures. Additionally, 31 people who came into contact with this case either through direct contact with the primary case or had other epidemiological links, became ill, and four cases of them died.
The outbreak was detected on 11 September, following the death of a 47-year-old woman from Antananarivo, who was admitted to a hospital with respiratory failure caused by pneumonic plague. The public health authorities Direction de la Veille Sanitaire et de la Surveillance Epid?miologique (DVSSE) immediately launched field investigations.
As of 28 September 2017, a total of 51 cases (suspected, probable and confirmed) of pneumonic plague, including 12 deaths were reported in the country. The diagnosis was confirmed by the Institut Pasteur de Madagascar by polymerase chain reaction test and using rapid diagnostic test.
In addition to the 51 suspected, probable and confirmed cases of pneumonic plague, and during the same period another 53 cases of bubonic plague including seven deaths have been reported throughout the country. One case of septicaemic plague has also been identified and they were not directly linked to the outbreak.
[h=3]Public health response[/h] The Ministry of Health activated crisis units in Antananarivo and Toamasina and all cases have been provided access to treatment at no cost. Active case finding and contact tracing are on-going and all pneumonic cases are being isolated and treated, and all contacts are receiving chemoprophylaxis.
There are additional ongoing key public health response measures which include:

• Ongoing investigation of new cases.
• Strengthening of the epidemiological surveillance in the affected and surrounding districts, including contact identification, administration of chemoprophylaxis, and monitoring close contacts of pneumonic plague cases.
• Disinsection of affected areas, including rodent and vector control.
• Raising awareness of the population about prevention and actions after exposure.
• Raising awareness among health care workers and providing information including infection control measures, and implementation of safe burial practices.

[h=3]WHO risk assessment[/h] Plague is an infectious disease caused by the bacteria Yersinia pestis, a zoonotic bacteria, usually found in small mammals and their fleas. It is transmitted between animals from their fleas. Humans can be contaminated by the bite of infected fleas, through direct contact with infected materials or by inhalation.
There are three forms of plague infection, depending on the route of infection: bubonic, septicaemic and pneumonic.

• Bubonic plague (known in mediaeval Europe as the 'Black Death') is the most common form of plague and is caused by the bite of an infected flea. Plague bacillus, Yersinia pestis, enters at the bite and travels through the lymphatic system to the nearest lymph node where it replicates itself. The lymph node then becomes inflamed, tense and painful, and is called a "bubo". At advanced stages of the infection the inflamed lymph nodes can turn into open sores filled with puss.
• Pneumonic plague-or lung-based plague- is the most virulent form of plague. Incubation period can be as short as 24 hours. Typically, the pneumonic form is caused by spread to the lungs from advanced bubonic plague. However, a person with secondary pneumonic plague may form aerosolized infective droplets and transmit plague via droplets to other humans. Untreated pneumonic plague is always fatal.
• Septicaemic plague occurs when infection spreads through the bloodstream, following a bubonic or a pneumonic plague.

Plague can be a very severe disease in people, particularly in its septicaemic and pneumonic forms, with a case-fatality ratio of 30?100% if left untreated. The pneumonic form is invariably fatal unless treated early, is especially contagious and can trigger severe epidemics through person-to-person contact via droplets in the air.
Plague is an endemic disease in Madagascar; cases of bubonic plague are reported nearly every year, during the epidemic season (between September and April). However, the ongoing pneumonic plague event has been reported in a non-endemic area and in densely populated coastal cities for the first time.
Pneumonic plague is a form of plague that is transmissible from person-to-person, with a potential to trigger severe epidemics if inadequately controlled. Detection of this outbreak occurred more than two weeks after the first case died during which cases travelled to different parts of the country, including the capital Antananarivo. Therefore, the overall risk at the national level is high. The overall regional risk is moderate due to frequent flights to neighboring Indian Ocean islands. The global risk is low.
[h=3]WHO advice[/h] [h=4]Prevention and control measures[/h] Preventive measures include informing people when zoonotic plague is present in their environment and advising them to take precautions against flea bites and not to handle animal carcasses. The most rapid and effective method for controlling fleas is to apply an appropriate insecticide formulated as a dust or low-volume spray. People, especially health workers, should also avoid direct contact with infected tissues such as buboes, or close exposure to patients with pneumonic plague. Important prevention and control measures include:

• Find and stop the source of infection.
• Protect health workers: inform and train them on infection prevention and control.
• Isolate: patients with pneumonic plague. They should be isolated so as not to infect others via air droplets.
• Surveillance: identify and monitor close contacts of pneumonic plague patients and give them a seven day chemoprophylaxis.
• Obtain specimens which should be carefully collected and sent to labs for testing.
• Ensure safe burial practices.

[h=4]Treatment[/h] Untreated plague can be rapidly fatal, so early diagnosis and treatment is essential for survival and reduction of complications. Antibiotics and supportive therapy are effective against plague if patients are diagnosed in time.
[h=4]Travel advice[/h] WHO advises against any restriction on travel or trade on Madagascar based on the available information. It is recommended to provide information at the ports of entry (airports, seaports) of Madagascar about the disease and the necessary protection measures required.
For more information, please see the WHO plague fact sheet link below:

 

[Shiloh]

Source: http://www.who.int/mediacentre/news/releases/2017/response-plague-madagascar/en/

[h=1]WHO scales up response to plague in Madagascar[/h] News release

1 October 2017 | Geneva - WHO is rapidly scaling up its response to an outbreak of plague that has spread to the capital and port towns, infecting more than 100 people in just a few weeks.
On Saturday, the Malagasy Government confirmed that the death of a Seychellois national was due to pneumonic plague. The basketball coach died in hospital in Antananarivo on Wednesday (September 27) while visiting the island nation for a sports event.
Health authorities are tracing people with whom he came into contact in recent days and who may have become exposed to the illness. Once identified, they will be given antibiotics to prevent infection as a precautionary measure.
The incident brings the death count to 21 since the outbreak was identified in late August; at least 114 people have been infected.
?WHO is concerned that plague could spread further because it is already present in several cities and this is the start of the epidemic season, which usually runs from September to April,? said Dr. Charlotte Ndiaye, WHO Representative in Madagascar.
?Our teams are on the ground in Madagascar providing technical guidance, conducting assessments, supporting disease surveillance, and engaging with communities,? she added. ?We are doing everything we can to support the Government?s efforts, including by coordinating health actors.?
Further deployments of WHO staff and through response partners in the Global Outbreak Alert and Response Network (GOARN) are underway, as well as increased supplies of antibiotics, personal protective equipment and other supplies.
WHO has released US$300,000 in emergency funds, as well as critical medical supplies, to quickly scale up operational efforts, and is appealing for US$1.5 million to support the response.
Plague is endemic to Madagascar, where around 400 cases of ? mostly bubonic ? plague are reported annually. Contrary to past outbreaks, this one is affecting large urban areas, which increases the risk of transmission. The number of cases identified thus far is higher than expected for this time of year.
Bubonic plague is spread by infected rats via flea bite, pneumonic by person-to-person transmission. The current outbreak includes both forms of plague. Nearly half of the cases identified so far are of pneumonic plague.
Plague is a disease of poverty. It thrives in places with poor sanitary conditions and inadequate health services. It can kill quickly if left untreated, but can also be cured by common antibiotics if delivered early.
The last reported outbreak in December 2016 was mainly bubonic plague occurring in remote areas...

 

[Shiloh]

Source: http://www.who.int/csr/don/02-october-2017-plague-madagascar/en/
[h=1]Plague ? Madagascar[/h] Disease outbreak news
2 October 2017

From 23 August to 30 September 2017, a total of 73 suspected, probable, and confirmed cases of pneumonic plague, including 17 deaths have been reported in Madagascar. The diagnosis was confirmed by the Institut Pasteur de Madagascar by polymerase chain reaction test or using rapid diagnostic test.
The outbreak started following the death of a 31-year-old male from Ankazobe District in the Central Highlands (Hauts-Plateaux), a plague-endemic area. Since then, the Ministry of Public Health of Madagascar enhanced field investigations, contact tracing, surveillance, and monitoring all close contacts.
As of 30 September, 10 cities have reported pneumonic plague cases and the three most affected districts include: the capital city and suburbs of Antananarivo (27 cases, 7 deaths), Toamasina (18 cases, 5 deaths), and Faratshio (13 cases, 1 death).
On 27 September, during the Coupe des clubs champions de l'oc?an Indien (a basketball championship held between 23 September and 1 October), a Seychellois basketball player, died in a hospital in Madagascar by pneumonic plague. The Ministry of Public Health of Madagascar immediately started an investigation and there is ongoing contact tracing of all the individuals he came into contact with. Chemoprophylaxis as a precautionary measure has been given to all close contacts.
In addition to the 73 cases of pneumonic plague, from 1 August to 30 September, 58 cases of bubonic plague including seven deaths have been reported. One additional case of septicaemic plague has also been reported, and one case where the type is not specified.
[h=3]Public health response[/h] The Ministry of Public Health of Madagascar activated crisis units in Antananarivo and Toamasina and all cases have been provided access to treatment at no cost.
There are public health response measures which include:

• Ongoing investigation of new cases
• Isolation and treatment of all pneumonic cases
• Active finding and tracing of contacts and provision of chemoprophylaxis
• Strengthening of the epidemiological surveillance in the affected and surrounding districts
• Disinsection of affected areas, including rodent and vector control
• Raising public awareness on prevention
• Raising awareness among health care workers and providing information to improve case detection, infection control measures
• Providing information about infection control measures during burial practices

[h=3]WHO risk assessment[/h] Plague is an infectious disease caused by the bacteria Yersinia pestis, a zoonotic bacteria, usually found in small mammals and their fleas. It is transmitted between animals from their fleas. Humans can be contaminated by the bite of infected fleas, through direct contact with infected materials or by inhalation.
There are three forms of plague infection, depending on the route of infection: bubonic, septicaemic and pneumonic (for more information, see the link below).

• WHO Plague Fact Sheet

Pneumonic plague-or lung-based plague is the most virulent form of plague and can trigger severe epidemics through person-to-person contact via droplets in the air. The incubation period can be as short as 24 hours. Typically, the pneumonic form is caused by spread to the lungs from an advanced bubonic plague. However, a person with secondary pneumonic plague may form aerosolized infective droplets and transmit plague via droplets to other humans. Untreated pneumonic plague is always fatal.
Plague is an endemic disease in Madagascar; cases (predominantly bubonic plague) are reported nearly every year, during the epidemic season (between September and April). However, the ongoing pneumonic plague event has been reported in a non-endemic area and in densely populated cities for the first time.
A pneumonic plague is a form of plague that is transmissible from person-to-person, with a potential to trigger severe epidemics if inadequately controlled. Detection of this outbreak occurred more than two weeks after the first case died during which cases travelled to different parts of the country, including the capital Antananarivo. Therefore, the overall risk at the national level is high. The overall regional risk is moderate due to frequent flights to neighbouring Indian Ocean islands. The global risk is low.
[h=3]WHO advice[/h] [h=4]Prevention and control measures[/h] Preventive measures include informing people when zoonotic plague is present in their environment and advising them to take precautions against flea bites and not to handle animal carcasses. The most rapid and effective method for controlling fleas is to apply an appropriate insecticide formulated as a dust or low-volume spray. People, especially health workers, should also avoid direct contact with infected tissues such as buboes, or close exposure to patients with pneumonic plague.
Important prevention and control measures are primarily intended to reduce human transmission and avoid increase in epidemic. These include:

• Advising the public to take all necessary precautions against flea bites and to not pick up or touch dead animals
• Implementing measures to control rodents hosts of Yersinia pestis (plague bacillus), especially rats
• Avoiding direct contact with infected tissues such as buboes, or close exposure to patients with pneumonic plague
• Early presentation to health care - go to the closest health center in the event of suspicious symptoms
• Health workers and people who are in direct contact with pneumonic plague patients must wear personal protective equipment
• Health workers should receive a chemoprophylaxis with antibiotics as long as they are exposed
• Safe management and burial of deceased cases

[h=4]Treatment[/h] Rapid diagnosis and treatment is essential to reduce complications and fatality. Effective treatment methods enable plague patients to be cured, if diagnosed in time. These methods include the administration of antibiotics as Aminoglycosides, Fluoroquinolones, Sulfonamides and supportive therapy.
[h=4]Travel advice[/h] Based on the available information to date, the risk of international spread of plague appears very low. WHO advises against any restriction on travel or trade on Madagascar based on the available information.
International travellers should be informed about the current plague outbreak and that plague is endemic in Madagascar. Travellers should also be aware that Madagascar is endemic for malaria and should consider the antimalarial prophylaxis recommended by WHO when travelling to Madagascar (see link below).

• International Travel and Health. List of countries, territories and areas. Vaccination requirements and recommendations for international travellers, including yellow fever and malaria.

The risk of infection withYersinia pestis for international travellers to Madagascar is generally low. However, travellers in rural areas of plague-endemic regions may be at risk, particularly if camping or hunting or if contact with rodents . Travellers should avoid contact with dead animals, infected tissues or materials, and avoid close contact with patients with pneumonic plague. Travellers can protect against flea bites using repellent products for personal protection against mosquitoes, which may equally be protective against fleas and other blood-feeding insects. Formulations (lotions or sprays) based on the following active ingredients are recommended by the WHO Pesticides Evaluation Scheme (WHOPES) : DEET, IR3535, Icaridin (KBR3023) or Picaridin. WHO guidance for control of rodent fleas that transmit bubonic plague can be found here:

• WHO guidance for control of rodent fleas that transmit bubonic plague

In case of sudden symptoms of fever, chills, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tainted sputum, travellers should immediately contact a medical service. Travellers should avoid taking antibiotics as prophylaxis unless recommended by medical professionals. Prophylactic treatment is only recommended for persons who have been in close contact with plague cases, or with other high risk exposures (such as bites from infected fleas or direct contact with body fluids or tissues of infected animals). Upon return from travel to Madagascar, travellers should be on alert for the above symptoms, and if symptoms appear, they should seek medical care and inform their physician about their travel history to Madagascar.

 

[Pathfinder]

Translation Google

Epidemic - General Alert on Pulmonary Plague

02.10.2017 | 8:35 News, alaune, Social2

Three people died from the plague in the space of a few hours in Antananarivo. The disease has also infected health workers

Uncontrollable. Three individuals died suddenly in three major hospitals of Antananarivo, on 28 September. Doctors immediately suspected the plague. On a rapid diagnostic test, their suspicions were confirmed. They all died after pneumonic plague. The first was a stranger, the coach of the Seychelles basketball team. The second, a woman returning from Toamasina on a bush taxi and was immediately taken to the hospital on a taxi-city, a source in the Ministry of Public Health . She would have bowed to this means of transport in the hospital grounds. All those who were in the same bush taxi that this woman should go to a health center for a contact chemo prophylaxis otherwise they risk disease. The last, a man living in the Atsimondrano district, transferred to a hospital in the city of Antananarivo. So far, the technicians of the Ministry of Health has not yet been determined how the victims have contracted the bacillus of pulmonary plague.

The number of people killed in Antananarivo would amount to five, with these cases, according to the announcement of the Ministry of Public Health, Professor Mamy Lalatiana Andriamanarivo Saturday. These would be the last event of death listed in Antananarivo. Rumors circulated, yet last night, on the presence of several deaths in Ambohimiandra, but neither the ministry nor the municipal office hygiene (BMH) have confirmed the information. Moreover, these sources said that the patients still undergoing treatment at anti-plague hospital in Ambohimiandra (CHAPA) and another large hospital in Antananarivo.

assigned health workers

In Toamasina, the situation would become unmanageable. Was counted until Saturday, five deaths since the first cases in early September. Currently, even the health workers is affected. Of the twenty people treated for pneumonic plague, seven are health workers, according to information sent yesterday. One patient reportedly escaped. This will further complicate the task. The Minister of Health, accompanied by technical and financial partners, will descent on site this week.
The representative of the World Health Organization (WHO), Professor Charlotte Ndiaye, said in an interview Saturday that "we are all on alert." She, however, reassured that there is no risk if the disease is supported in time .She urges good hygiene, hand washing, to prevent the circulation of the disease.

Special measures

On Saturday, twenty four deaths and one hundred twenty five suspected plague cases were recorded throughout Madagascar, according to latest statistics from Madagascar. The number of pulmonary cases is sixty eight, while the bubonic is fifty five. A victim notified in Antananarivo was septicemic. Faced with this plague raging Madagascar, the Malagasy government, supported by technical and financial partners, has decided to suspend all public events until further notice to prevent the spread of the disease, as announced Premier Olivier Mahafaly Solonandrasana Saturday at an emergency meeting on the strategy against the plague, to Mahazoarivo. "We do not know who is affected by the disease and who is not," said an informed source. disinfection and disinfestation operations will, also, operated at schools, parking lots, public transportation means. International and domestic flights will not be suspended, but monitoring the passengers' health will be strengthened. Sanitation, awareness will be strengthened.

Miangaly Ralitera

http://www.lexpressmada.com/blog/actualites/epidemie-alerte generale sur la peste pulmonaire/

 

[Shiloh]

Source: https://www.outlookindia.com/newsscroll/madagascar-plague-death-toll-climbs-to-30/1160817

05 October 2017 Last Updated at 12:55 am
Madagascar plague death toll climbs to 30

Antananarivo, Oct 4 An outbreak of high contagious plague has claimed 30 lives in the impoverished Indian Ocean island nation of Madagascar over the last two months, authorities said today.

"We have recorded 194 suspected cases of plague, including 30 deaths," health official Manitra Rakotoarivony said in a statement, updated the death toll from 25.

Madagascar has a history of plague outbreaks almost every year since 1980, often sparked by rats fleeing forest fires.

The current outbreak is unusual as it has affected urban areas, increasing the risk of transmission, said the World Health Organisation...

 

[Pathfinder]

Translation Google

Epidemic - Victims of plague increase

05.10.2017 | 8:35 News, alaune, Social0

The lifeless body of a pulmonary plague suspect was buried in Anjanahary yesterday. Eight patients were admitted to the hospital the same day, in Antananarivo.

Plague is far from being under control. The eighth plague suspect dead in Antananarivo city, was planted at the grave of Anjanahary, late in the afternoon yesterday. From Manandriana in the district of Avaradrano, he died on the way to provide care in a large hospital in Antananarivo, the same day. "Clinical signs have led us to say that it is a pulmonary plague. It would have presented with fever, cough with sputum streaked with blood, chest pain. The rapid diagnostic test (RDT) has confirmed, "said a concurring source.

Neither that case nor the teenager died in Ilafy and buried Ambohimailala Tuesday are still listed in the latest statistics from the Ministry of Public Health, posted yesterday at 11:00 30. against two deaths in the district Atsimondrano and to Tsiroanomandidy, between 3 and 4 October, were raised.

In addition, there was the increase in the number of patients admitted to health facilities in Antananarivo city yesterday. Six central hosptalier Soavinandriana and two anti-plague hospital in Ambohimiandra (CHAPA). Between 3 and 4 October, thirty-five living suspects have been identified in six districts, including fifteen in Antananarivo city, thirteen in Toamasina I, three in Ambohidratrimo, yet according to Ministry concerned.

Spread

The Department of Public Health welcomes this increase in the number of patients admitted to hospitals. "This means that the population begins to know the precautions to take in case of suspicious symptoms. Treated on time, they will be cured, "said a source. Others interpret as the propagation of the bacteria in the capital. That said, all must be vigilant. In case of fever, chills, body aches and head, weakness, vomiting and nausea, inflamed and painful glands, shortness of breath and cough, with traces of blood in sputum, the consultation a doctor is required.

It is only now that the government, led by Prime Minister Olivier Mahafaly Solonandrasana seems to be aware of the magnitude of the phenomenon, multiplying activities against the disease, when the first case was recorded in the month 'August. These activities include, among others, the establishment of a health dam in the parking lots of the national area, the requirement of compulsory identity statement in these parking lots, as it is via the transit that pulmonary plague has spread in Toamasina and Antananarivo. There is, moreover, a devolution of care in all health facilities. Yesterday, a restricted government council, with technical and financial partners on the plague epidemic, was held at the State Palace in Mahazoarivo. And in the same day an update and validation workshop of the response plan to the plague took place at the Hotel Colbert. A more focused strategy is required to restrict the number of victims.

Twenty Districts Affected by Plague

Twenty districts are now affected by the plague. Most are plague areas, but the disease has also spread to Mahajanga, Toliara, and Toamasina, non-plague areas, according to the Ministry of Public Health. In these twenty districts, the ministry counted ninety four cases. Sixty-eight of them occurred in Antananarivo and Toamasina forty. There are still six months before the end of the plague season.

Miangaly Ralitera

http://www.lexpressmada.com/blog/actualites/epidemie-les-victimes-de-la-peste-augmentent/

 

[Shiloh]

Source: http://apps.who.int/iris/bitstream/...nic+Plague+Outbreak+in+Madagascar+-+Sitrep+01

Plague Outbreak
Madagascar
External Report 01

...As of 3 October 2017, a total of 194 cases (suspected, probable and confirmed) with 30 deaths (case fatality rate 15.5%) have been reported from 20 districts in 10 regions. Of these, 124 cases and 21 deaths (case fatality rate 16.9%) had the pneumonic form of the disease. Eight healthcare workers from one health facility in Tamatave have contracted pneumonic plague. Of 29 cases with specimens collected, 19 (66%) have been confirmed by either polymerase chain reaction (PCR) or RDT performed at the Institut Pasteur de
Madagascar. On 3 October 2017, 37 new cases including 2 deaths have been reported....

 

[Gert van der Hoek]

Madagascar in panic amid raging ?double plague? outbreak; dozens dead

All public gatherings banned, schools closed as people swarm pharmacies.

BETH MOLE - 10/6/2017


An unusually deadly seasonal outbreak of plague has gripped the island nation of Madagascar. As of Friday, 258 have been sickened and 36 have died just since August, according to Madagascar?s Ministry of Public Health.

To try to stifle the spread, the government has forbidden public gatherings, including sporting events, and schools have closed for insecticide treatments that kill plague-spreading fleas. People have swarmed pharmacies, desperately seeking face masks and any antibiotics they can get. The World Health Organization on Friday announced that it has released $1.5 million in emergency funds and delivered nearly 1.2 million antibiotic doses to help combat the outbreak.

Enlarge / Distribution of plague as of 2016.

WHO​

Plague, caused by the bacterium Yersinia pestis, is endemic to Madagascar and pops up all year-round. But outbreaks can erupt between September to November, with seasonal shifts in rat and flea populations. Rats, which harbor the bacteria, tend to see their populations plump and peak around harvest times in July and August. A boom in the flea population, which transmits the disease, follows in tandem. But as crops are harvested and the weather cools, the rat population shrinks, and the surging, hungry batch of fleas turns to humans.

The island has been battling the disease since it arrived there on steamboats from India in 1898. (The disease still appears in many countries around the world, including the US, but most epidemics occur in African countries.) Madagascar got a handle on its seasonal outbreaks during the 1950s with the help of antibiotics, insecticides, and better hygiene campaigns. But it lost its grip in the 1990s when it started seeing increases in case counts. In recent years, the country has tallied between 275 and 675 cases annually (PDF).

But this year is different. The disease is spreading not just in rural, agricultural areas; it?s also spreading in cities. As of September 30, the disease had taken hold in 10 cities across the island, including the capital, Antananarivo.

?WHO is concerned that plague could spread further because it is already present in several cities and this is the start of the epidemic season, which usually runs from September to April,? Dr. Charlotte Ndiaye, WHO representative in Madagascar, said in a recent statement.

READ MORE

 

[Gert van der Hoek]

Plague: Madagascar schools closed as death toll rises to 42

October 8, 2017

Schools in several cities across Madagascar will stay closed this week due to an outbreak of bubonic plague, with the death toll rising to 42, the Health Ministry said on Sunday. The government had already prohibited crowds from gathering in order to curb the further spread of the dangerous disease that had sickened 343 people as at Sunday, according to Health Ministry figures.

On Friday, the ministry put the death toll at 36, with 250 sickened. “In the heavily populated capital, Antananarivo, 142 people have been infected. Schools in the affected cities of Antananarivo, Toamasina and other regions have been closed for a week,” the health ministry said.

Outbreaks of bubonic plague are common in Madagascar, which lies off Africa’s south-eastern coast, but the most recent outbreak has included cases of the more serious pneumonic form of plague. About 400 cases of plague are reported in Madagascar every year, most of them bubonic, which is transmitted by flies.

The much rarer pneumonic strain of the disease that is spread person-to-person is fatal unless treated within 24 hours. The World Health Organisation (WHO) said it had delivered 1.4 million doses of antibiotics to Madagascar in view of the plague.

“With this up to 5,000 infected people can be treated and 100,000 can be given a prophylaxis. With early diagnosis, the chances of recovery are good,” said WHO.

 

[Shiloh]

Source: https://reliefweb.int/report/madaga...r-external-situation-report-02-9-october-2017
[h=1]Plague outbreak - Madagascar - External Situation Report 02 - 9 October 2017[/h] Report

from World Health Organization Published on 09 Oct 2017 ? View Original
1. Situation update
The outbreak of plague in Madagascar continues to evolve. Since our last report on 4 October 2017, a total of 230 new suspected cases including 17 deaths (case fatality rate 7.4%) were reported. Between 1 August and 8 October 2017, a total of 387 cases (suspected, probable and confirmed) including 45 deaths (case fatality rate 11.6%) have been reported from 27 out of 114 districts in the country. Of these, 277 cases (71.6%) had the pneumonic form of the disease, 106 were bubonic plague, one case was septicaemic plague, and 3 cases were unspecified...

 

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Translation Google

Back-to-School Reporting, Prohibited Meetings (Updated)

The plague in Madagascar rises to 54 dead

Posted by IPR 1 hour ago

Since the beginning of August 2017, Madagascar is facing an epidemic of plague. From 1 August to 11 October, 500 cases were counted. 54 people have died. To fight against the spread, the back-to-school period was postponed by one week. The public gatherings were also temporarily suspended. At the same time, 1,000 volunteers from the Malagasy Red Cross have been mobilized in districts affected by the epidemic.

According to a latest report published on Wednesday 11 October by the Ministry of Health Malagasy, the record of the plague climb to 54 deaths. Since August, 500 people have been infected with the disease. To combat the spread of the epidemic, the government calls for "civism" and deplore this "brutal apparition", "outside the seasonal period".

Airport checks were strengthened and public gatherings banned. The return to school was also postponed for a week so as not to expose the children to "allergies following the disinfection of the buildings". The government is also calling for health services as soon as symptoms such as "sudden onset of fever, headache, cough, difficulty breathing or sputum with blood" appear.
...


http://www.ipreunion.com/actualites...a-lutte-contre-la-peste-s-organise,70319.html