Madagascar Plague Outbreak – Update

The latest World Health Organization Situation Report has indicated that the number of new cases of pneumonic plague is decreasing. The epidemiological curve (below) shows clearly that the outbreak is rapidly declining.


Figure. Total number of plague cases reported in Madagascar, 1 August – 30 September

From 1 August to 30 October 2017, a total of 1 801 suspected cases of plague, including 127 deaths (case fatality rate 7%), have been reported. Of these, 1 111 (62%) were clinically classified as pulmonary plague, 261 (15%) were bubonic plague, one was septicaemic, and 428 were unspecified. All isolates of Yersinia pestis to date have been susceptible to the recommended antibiotics.

The risk of regional spread is moderate due to the occurrence of frequent travel by air and sea to neighbouring Indian Ocean islands and other southern and east African countries. The risk of international spread is mitigated by the short incubation period of pneumonic plague, implementation of exit screening measures and advice to travellers to Madagascar, and scaling up of preparedness and operational readiness activities in neighbouring Indian Ocean islands and other southern and east African countries, including South Africa. The overall global risk is considered to be low. To date, no confirmed cases of plague in travellers from Madagascar have occurred.

The full WHO report is available at

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