A. Situation analysis
Description of the disaster
A plague outbreak in Madagascar has raised concern in neighbouring countries. As of 12 October, a total of 684 cases (suspected, probable and confirmed) including 57 deaths (CFR 8.3%) have been reported from 35 out of 114 districts. Of these 474 were clinically classified as pneumonic plague.
The Madagascar Ministry of Health (MoH) reported caseload on 16 October was 805 (confirmed and suspected) with 74 deaths.
While Madagascar is accustomed to seasonal bubonic plague outbreaks characterised by a combination of pneumonic and bubonic plague. Pneumonic plague, which currently counts 65% of the caseload, is transmitted from person-to-person and the fact that the majority of the cases are occurring in urban areas, make this year’s outbreak a serious concern not only for Madagascar but for the region.
Consequently, WHO has classified the current outbreak in Madagascar as a grade 2 emergency; WHO liaison officer expressed concern of the outbreak and considered Seychelles as a priority country, emphasized on preparedness and stated that support can be provided.
One Seychellois passed away in Madagascar after contracting the disease in Madagascar during a basketball tournament in the early weeks of October.
On 10 October 2017, the Seychelles Ministry of Health notified WHO of a probable case of pneumonic plague.
The probable case is a 34-year-old man who had visited Madagascar and returned to Seychelles on 6 October 2017. He developed symptoms on 9 October 2017 and went to a local health centre. Based on a medical examination and reported history of recent travel to Madagascar, pneumonic plague infection was suspected and he was immediately referred to hospital where he was isolated and treated. A rapid diagnostic test (RDT) performed within the country on 11 October 2017 on a sputum sample was weakly positive. The specimen was sent to the WHO Collaborating Center for Plague at the Institut Pasteur in Paris, France.
Between 9 and 11 October 2017, 08 of his contacts developed mild symptoms and were isolated and treated.
Two other suspected cases, without any established epidemiological link to the probable case, were identified, isolated and treated.
Laboratory results released by the Institut Pasteur in France on 17 October 2017 showed that all 10 specimens were negative for plague. All the suspected cases have now been discharged after completing their course of treatment. To date, no plague cases have been confirmed in Seychelles.
Nine countries and overseas territories have been identified as high risk for plague outbreak by having trade and travel links to Madagascar. These priority countries include Comoros, Ethiopia, Kenya, Mauritius, Mozambique, Reunion, Seychelles, South Africa, and Tanzania.
Plague is an infectious disease caused by the bacteria Yersinia pestis, zoonotic bacteria, usually found in small mammals and their fleas. It is transmitted between animals through fleas. Humans can be infected through: the bite of infected vector fleas, unprotected contact with infectious bodily fluids or contaminated materials and the inhalation of respiratory droplets/small particles from a patient with pneumonic plague.
The RCSS seeks for CHF 66,520 for plague preparedness for community surveillance for 23,809 people (25% of 95,236 population) at risk through provision of training of volunteers on the plague, mass awareness and community engagement and accountability activities. The DREF will also enable the RCSS to coordinate with the government and other agencies in monitoring the situation and planning for a coordinated response.