Global & Disaster Medicine

Madagascar: 93 suspected plague patients have been registered between [1 Aug 2017] and [25 Sep 2017] and 5 of them have died



Plague around the world, 2010–2015
E. Bertherata

“Plague is a bacterial infection mainly affecting small mammals and transmitted by fleas. The geographical distribution of the disease is very focalized. Occasionally, the pathogen Yersinia pestis can infect humans through infected flea bites. Human plague is a serious disease, particularly in its septicaemic and pneumonic forms. The pneumonic form, invariably fatal unless treated early, is especially contagious and can trigger terrifying epidemics through direct person-to-person contact. In these circumstances, plague is simultaneously a medical and a public health emergency.

Between 1 January 2010 and 31 December 2015, 3248 cases of plague in humans were reported, resulting in 584 deaths (Table 1). The principal animal reservoir (which differs from region to region) and local socioeconomic conditions are determinants of the epidemiological characteristics of the disease and the risk of transmission to humans. Plague is a disease of poverty in Africa, South America and India, where the animal reservoir essentially comprises commensal rodents, but tends to be a sporadic disease associated with outdoor occupations in the other endemic regions. ……..”


“……In Africa, 4 countries still regularly report cases. Madagascar is the most seriously affected country in the world. The surveillance system is relatively effective, thanks to the support of the national Pasteur Institute. Thus, specimens are taken from 95% of suspected cases and nearly 55% of these are confirmed as plague cases. Incidence has declined in the last 2 years but there has been an increase in the overall case fatality rate (23% in 2015) associated with the higher frequency of pneumonic forms (23.3%). This increase in serious forms of the disease is symptomatic of the deteriorating fabric of the health system as a result of the recent social and political crisis in the country. …..”


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