Madagascar: Plague (Epidemic) Emergency Plan of Action (EPoA) (MDRMG013)

A. Situation analysis

Description of the disaster

Madagascar has suffered regular seasonal outbreaks of bubonic plague over the last 4 years, normally extending from August to April each year. However, this year, the first cases of person to person to transmission via pneumonic plague have occurred. The first death of a patient infected with the plague was notified on the 27th of August. A total of 20 districts across Madagascar have reported cases of the plague and as of 3 October, the cumulative number of cases is 194 with 50 deaths (case fatality rate 15.5) recorded, 124 of these cases being recorded as pneumonic transmission. The occurrence of pneumonic transmission in urban areas, increases the risk of substantial spread, and high cases loads significantly and requires urgent and comprehensive response to save lives.

Specimens from suspected cases were submitted to the Institute Pasteur de Madagascar and confirmed cases were identified by either polymerase chain reaction or rapid diagnostic tests. Antananarivo is one of the most affected areas followed by the port city of Toamasina, and the rural district of Faratsiho. Of the total deaths from the plague, one is a foreigner who was visiting Madagascar, and to date 8 health care workers have been infected.

In order to control pneumonic plague, swift and comprehensive response including early identification and referral of cases, effective risk communication and community engagement, infection prevention and control, safe burials, and vector control is required.

From 1 August to 04 October 2017, 10 Regions across 20 Districts and 115 Villages in Madagascar have been affected by the plague, namely: