On
Nov 21 the WHO reported that an outbreak of Plague in Madagascar. The
first case, a male from Soamahatamana village in the district of
Tsiroanomandidy, was identified on 31 August. Since that time a total of
119 cases of plague have been confirmed, including 40 deaths. Cases
have been reported in 16 districts of seven regions. Antananarivo, the
capital and largest city in Madagascar, has also been affected with 2
recorded cases of plague, including 1 death.
A national task force has been activated to manage the outbreak. With
support from partners – including WHO, the Pasteur Institute of
Madagascar, the “Commune urbaine d’Antananarivo” and the Red Cross – the
government of Madagascar is putting in place strategies to control the
outbreak.
This outbreak report has received world-wide press attention.
Plague is a bacterial disease caused by Yersinia pestis, which
primarily affects wild rodents. It is spread from one rodent to another
by fleas. Humans bitten by an infected flea can develop the disease.
Plague is endemic in many parts of the world including the Western
United States. The United States has an average of 7-10 cases of plague a
year.
Plague is easily treated with antibiotics, but can be highly lethal if left untreated. Plague may occur in three varieties.
Bubonic plague is the most common variety of the disease. It's named
after the buboes (swollen lymph nodes) which typically develop within a
week after an infected flea bites.
Septicemic (blood infection) plague is a rarer form of the disease that
can occur as the first symptom of plague, or may develop from untreated
bubonic plague. This form results from bites of infected fleas or from
handling an infected animal.
Pneumonic plague is the rarest form of the disease and may develop from
inhaling infectious droplets or may develop from untreated bubonic or
septicemic plague after the bacteria spread to the lungs. Pneumonic
plague is the most serious form of the disease and is the only form of
plague that can be spread from person to person. Only 2% of the cases of
plague in this outbreak in Madagascar have been of the pneumonic
variety.
Plague in the developing world is a disease of poverty (people living in
close proximity to rats) and the diseases high death toll is the result
of lack of access to healthcare.
Individuals can reduce their risk of exposure to plague by avoiding
close contact with rodents or flea infested animals, by using insect
repellent and not handling dead animals without proper protective
equipment.
Mercy Ships current infection control and patient screening practices
should prevent any cases of plague embarking on the Africa Mercy. The
hospital is also equipped with appropriate medications to treat any
cases of plague that might occur.
The current plague outbreak in Madagascar is not expected to have an
adverse effect on Mercy Ships operations or place personnel at any
increased risk.
Mercy Ships is carefully monitoring the situation and will make programmatic adjustments if necessary to protect staff and crew.
