Plague in Madagascar
Three deaths in Ambositra in recent days
During the past week or so, three deaths due to plague have been reported in the central Madagascar city of Ambositra, in the Amoron’i Mania region according to local media.
According to Gendarmerie, or police reports, an 8-year-old girl from the commune of Ivato-Centre and a 7-year-old boy from the commune of Antoetra died on December 10 from bubonic plague.
Less than a week prior, a 42-year-old man from Ivato-Centre also died of plague.
The reports note that plague continues to rage in the Amoron’i Mania region. While no official statistics are available, the media account describes these as the “umpteenth” cases in the region since August.
According to Gendarmerie reports, there have been at least twenty suspicious deaths linked to the plague since September, according to Gendarmerie reports.
Plague is endemic on the Plateaux of Madagascar. A seasonal upsurge, predominantly of the bubonic form, usually occurs yearly between September and April.
Interview with New Mexico State Public Health Veterinarian, Paul Ettestad, DVM about plague
According to the general secretary of the Madagascar Ministry of Health, between 300 and 600 suspected cases are reported each year, with about 30 cases of pulmonary plague and 10 to 70 deaths.
In 2017, Madagascar recorded 2,348 confirmed, probable and suspected cases of plague leading to 202 deaths — a case-fatality rate of 8.6%, according to the World Health Organization.
Plague is not just a disease of historical record, it’s presence around the world still exists. However, the good news is in recent years, the number of global plague cases has dropped significantly as compared to a decade or so before.
Dr Terence Lam with the Hong Kong Centre for Health Protection (CHP) of the Department of Health (DH) put together the numbers and I will present some of them here:
Globally, the total number of human plague cases reported to the World Health Organization (WHO) from 1999 to 2008 was on average 2,334 cases annually.
In 2018, the total number of cases worldwide decreased about tenfold to 243 cases.
From 2013 to 2018, a total of 2,886 cases were reported worldwide to WHO and the top five countries were: Madagascar (2,323 cases; 80%), Democratic Republic of the Congo (DRC) (410 cases; 14%), Peru (40 cases; 1%), the United States of America (USA) (40 cases; 1%) and United Republic of Tanzania (36 cases; 1%)3. Other countries with small number of cases detected in the period included Uganda (22 cases), Mainland China (5 cases), Mongolia (5 cases), Bolivia (3 cases), Kyrgyzstan (1 case) and Russian Federation (1 case).
Among all the strains isolated, all remained susceptible to antimicrobial agents.
Plague is a communicable disease that affects rodents (including rats), some animals and humans. It is caused by the bacteria Yersinia pestis, which is transmitted from an infected animal (mainly rodent) to humans through the bite of infected animal’s fleas.
In addition, people can also contract plague when cuts or other breaks in their skin come into contact with the body fluid or tissues of infected animals, or through inhalation of respiratory droplets from infected patients.
There are three main forms of plague infection: bubonic, pneumonic and septicemic. Plague patients should be isolated and treated with appropriate antibiotics.