Madagascar’s Plague Outbreak Requires International Action

Madagascar is currently in the grip of an unfolding epidemic, with hundreds of people infected with the pneumonic plague. What led to the outbreak, and how can health authorities prevent its spread?

Because the plague is endemic to Madagascar, outbreaks are not unusual. But this year, the outbreak emerged much earlier than usual and has spread in a unique manner.

According to the World Health Organization, the outbreak was first identified after a 31-year-old man died in the Ankazobe District of the Central Highlands. As is common procedure following a suspected infectious disease death, the Ministry of Public Health began investigating the man’s close contacts to ascertain if a wider health problem existed. And they soon discovered a spiraling infection trail.

Since August it’s estimated that at least 124 people have died, and an additional 1,192 infection cases have been logged. There have also been around 70 cases of bubonic plague, but it is the much more virulent pneumonic plague that has authorities worried. 

Pneumonic plague is considered the most aggressive form of the disease, as it can spread through person-to-person contact. Otherwise known as lung-based plague, the disease arises when an advanced infection moves to a person’s lungs.

At this stage, the sufferer can then infect others via coughing or sneezing. Incubation time is very short — just 24 hours in most cases — and if untreated the pneumonic plague is always fatal.

Stephane Michaud, director of emergencies at the Canadian Red Cross, told The Globe and Mail that the situation is under control — at least in the short term: “For now, they are able to handle the clinical caseload of plague, and the main effort is at the community level to prevent further spread of the disease.”

While the World Health Organization believes the risk of a worldwide epidemic is low, the threat to local regions could escalate if global health authorities do not properly address this crisis.

Antananarivo and Toamasina, the two largest cities in Madagascar, have experienced the greatest concentration of infections to date. Densely populated urban areas pose challenges for disease control efforts because of the difficulty in  isolating infections. Additionally, cities tend to have more people traveling through to other regions, further increasing the risk of the pneumonic plague spreading beyond Madagascar.

At present there are no confirmed causes of the plague outside of Madagascar*. A number of vacationers flock to the region however, so while the global risk remains low, heightened screening procedures may be put in place for some tourists as they return to their home countries.

Even so, it’s unusual for the plague to spread via long distance air travel due to the short window of incubation. Generally, infected people will be too ill to travel or can be easily isolated.

The good news is that the plague is highly treatable with antibiotics, and around 780 people have been cured since August 1. Furthermore, six of the affected districts in Madagascar have now reported zero cases for at least 15 days, meaning that the transmission risk in those regions is under control.

And despite an unusually high number of infections, the outbreak is behaving in roughly the same way as local authorities observe every year. Therefore, if health officials can contain these infections, there’s every reason to think that this situation can be resolved relatively swiftly.

Such action hinges on international aid to ensure that Madagascar’s authorities have all the necessary tools to stop the plague in its tracks. A global appeal for a further $5.5 million is underway to fund health centers, antibiotics deployment and more.

 

*Correction: An earlier version of this post incorrectly implied that a number of countries have reported cases of the plague, with the Seychelles Islands among them. A WHO representative has confirmed this is not accurate. There have been no confirmed cases outside of Madagascar and, to date, those reported in the Seychelles Islands have all been negative.

Photo Credit: CDC Global/Flickr

47 comments

Marie W
Marie W5 months ago

Thank you for sharing!

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Stephanie s
Stephanie Y11 months ago

This gets no media attention. Shard, thank you

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Stephanie s
Stephanie Y11 months ago

This gets no media attention. Shard, thank you

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Kathryn I
Kathryn I11 months ago

Without question, Madagascar needs as much help as possible in this regard, sadly.

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heather g
heather g11 months ago

Madagascar certainly needs more assistance - especially as these serious diseases and deaths recur every year.

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Kathryn I
Kathryn I11 months ago

This is so heartbreaking. These people have enough problems even if this weren't the case. Thanks

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Ellie M
Ellie M11 months ago

ty

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Ruth S
Ruth S11 months ago

Thanks.

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Winn A
Winn Adams11 months ago

This didn't have to happen

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Winn A
Winn Adams11 months ago

:-(

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