Madagascar: Plague Epidemic - Joint Situation Report #5 as of 16 November 2017


This report is published under the coordination of the National Office for Risk and Disaster Management (BNGRC), with input from all relevant Ministries and the Humanitarian Country Team, which includes the United Nations System in Madagascar. It covers the period until 13 November 2017.


  • The epidemic remains active in 09 health districts.
  • A total of 2,158 cases have been recorded from 01 August to 13 November 2017, of which 76 per cent of were pneumonic.
  • About 60 per cent of the 174 total deaths occurred at community level.
  • 1,180 patients have been cured since the beginning of this epidemic, 28 others are receiving treatment in hospitals.
  • There has been a marked decrease in new cases, from 502 cases the week of 02 to 08 October to 70 cases the week of 06 to 12 November).
  • 7,166 people who had contact with patients with pneumonic plague completed their prophylactic treatment, out of 7,270 identified people.
  • Eight international airports and one port have established sanitary control posts.

Situation Overview

Although plague is endemic in Madagascar, this season has been uncharacteristic: it started a month early, has been predominately of the pneumonic form, and has most affected the largest urban centers of Madagascar (Antananarivo, Toamasina, Fianarantsoa and Antsirabe). Many of the districts current affected have no experience of the disease, which represents another challenge in addition to the difficulties in controlling the epidemic in urban areas.

The total number of cases (2,158) is already 5 times higher than the average annual total of 400 (September to April). However, there is a clear decrease in plague cases, from 502 cases during epidemiological week 40 (02-08 October) to 70 cases during week 45 (06-12 November 2017).

The spread of pneumonic plague in high-density urban areas is faster, with a risk of large-scale epidemics, while the implementation of health and non-health responses is confronted with access problems (difficulty in tracing contacts, especially in slums) and the frequent moving of people. The capital city of Antananarivo), the country’s trade and transport hub, is most affected by this epidemic.

Pneumonic plague due to person-to-person transmission by air poses a high health risk for all actors involved in the response, including health service providers in hospitals and health centers, social workers, health workers security and defense forces, journalists, hygienists, communicators, volunteers, etc. Since the beginning of the epidemic, 82 health personnel have been infected (with no deaths).

The epidemic has had consequences for tourism with the cancellation of cruises, but the situation is being addressed with the direct involvement of the World Tourism Organization. School has been suspended for one month.


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