Plague in Madagascar (28 September 2017)

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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.


  • 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.