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Plague in Madagascar

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    Posted: September 30 2017 at 1:57pm

PLAGUE OUTBREAK IN MADAGASCAR KILLS 20 – WHO

Humans bitten by an infected flea usually develop a bubonic form of plague, which swells lymph nodes and can be treated with antibiotics.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: September 30 2017 at 4:11pm
i wonder if it has the ability to become resistant to antibiotics??
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Death toll rises to 24
Outbreak of the PLAGUE kills at least 24 people and forces government to BAN public gatherings in Madagascar to halt the spread



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Dozens dead as plague outbreak menaces Madagascar

By David McKenzie, CNN

Updated 1703 GMT (0103 HKT) October 4, 2017



Johannesburg (CNN)An unusually widespread outbreak of the plague is menacing Madagascar.

At least 24 people have died and more than 130 have been infected with plague across the country, according to the World Health Organization.
    Plague is endemic to the country, but "contrary to past outbreaks, this one is affecting larger urban areas and ports, which increases the risk of person-to-person transmission," WHO spokesman Tarik Jasarevic said.
    Among the reported cases, almost 60 were the more common bubonic plague, including seven deaths. More than 70 -- including 17 deaths -- are suspected to be pneumonic plague, which is more severe.
    Ten cities were reporting pneumonic cases as of September 30, including the capital, Antananarivo, increasing chances of the disease spreading.
    Plague is caused by infection with the bacterium Yersinia pestis and is typically spread through the bite of infected fleas, frequently carried by rats, causing bubonic plague. Symptoms include painful, swollen lymph nodes, called bubos, as well as fever, chills and coughing.
    Pneumonic plague is more virulent or damaging and is an advanced form characterized by a severe lung infection. The infection can be transmitted from person to person via airborne droplets. The incubation period is short, and an infected person may die within 12 to 24 hours.
    Children don face masks in Antananarivo, Madagascar.
    Children don face masks in Antananarivo, Madagascar.

    An unusual outbreak

    An estimated 400 cases of plague are reported in Madagascar every year, mostly the bubonic variety, but the current outbreak has affected more areas and started earlier than usual.
    It's also unusual for large urban areas to be affected, as they have been this year, the WHO states.
    Outbreaks typically occur during the rainy season as "the rains drive the rodents out," said Daniel Bausch, director of the UK Public Health Rapid Support Team. Launched in 2016, this team consists of clinicians, scientists and academics deployed to tackle outbreaks of disease around the world within 48 hours.
    Bausch is sending two of his team members to Madagascar this week to collaborate with the WHO, which is assembling a team of experts to help the Madagascar Ministry of Public Health.
    "The thing that is unusual is that this is the beginning of the season," Bausch said. "Usually, after six months, you have around 200 cases. Now, we have (more than) 130 in just the first month of the season."
    It's also unusual that more than half of the cases reported are of pneumonic plague, he said.
    The outbreak began after the death of a man in the central highlands of the country -- a plague-endemic area -- after which the Ministry of Public Health began investigating and tracing his contacts, according to the WHO.
    In late September, a man from the Seychelles, in Madagascar to take part in the Indian Ocean Club Championship basketball tournament, died in a hospital from pneumonic plague. Health officials are urgently tracing individuals who had contact with the man and have started an investigation into the case.
    Officers from the Ministry of Public Health work on rat traps in a primary school in Antananarivo.
    Officers from the Ministry of Public Health work on rat traps in a primary school in Antananarivo.

    Treatment and prevention

    The government has mobilized resources to spray schools and other public places to fight fleas and rodents and curb the spread of infection.
    People have also been lining up at pharmacies in the capital -- some wearing face masks -- to get medications or protection from infection.
    People line up at a pharmacy in downtown Antananarivo.
    People line up at a pharmacy in downtown Antananarivo.
    If treated quickly, plague can be cured with common antibiotics, but authorities have warned people not to self-medicate. Rapid diagnosis is the essential element in curing plague, particularly the pneumonic strain.
    Join the conversation

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    Some public events have been banned, and children have been asked to stay home.
    "People associate plague as one of those fearful diseases, but it's a concern if not treated," Bausch said. It's now important to ensure means "to control the rodents and identify and treat people early."

    CNN's Meera Senthilingam contributed to this report.


    Source video and map:   http://edition.cnn.com/2017/10/04/health/madagascar-plague-outbreak/index.html

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 05 2017 at 12:58pm
    The death toll is now 30
    Both types (bubonic + pneumonic) are involved in this outbreak.
    Hundreds are ill.
    The disease is predicted to spread.


    It is treatable with antibiotics, if caught early enough and containable with pesticides if your country can afford them.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Posted: October 07 2017 at 9:02am
    A few more cases....

    Originally posted by BBC BBC wrote:

    More than a million doses of antibiotics have been delivered by the World Health Organization to fight an outbreak of plague in Madagascar which has killed at least 33 people.

    http://www.bbc.com/news/world-africa-41537193
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: October 07 2017 at 2:43pm
    I looks endemic to me.  Doxycycline takes it out and there is no evidence of drug resistance, since it is usually wiped out pretty quickly these days.   Pneumonic involvement is, of course, a big concern. 

    =========

    Plague is endemic to Madagascar, where around 400 cases of – mostly bubonic – plague are reported annually. Contrary to past outbreaks, this one is affecting large urban areas, which increases the risk of transmission. The number of cases identified to date is higher than expected for this time of year. 

    Bubonic plague is spread by infected rats via flea bite while pneumonic is transmitted person-to-person. The current outbreak includes both forms of plague. Nearly half of the cases identified so far are of pneumonic plague. 

    The last reported outbreak in December 2016 was mainly bubonic plague occurring in remote area.

    http://www.un.org/apps/news/story.asp?NewsID=57833#.WdlJyEzMyCQ

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    Post Options Post Options   Thanks (1) Thanks(1)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 09 2017 at 11:57am

    Plague outbreak - Madagascar - External Situation Report 02 - 9 October 2017

    REPORT
    from World Health Organization
    Published on 09 Oct 2017 View Original

    1. Situation update

    The outbreak of plague in Madagascar continues to evolve. Since our last report on 4 October 2017, a total of 230 new suspected cases including 17 deaths (case fatality rate 7.4%) were reported. Between 1 August and 8 October 2017, a total of 387 cases (suspected, probable and confirmed) including 45 deaths (case fatality rate 11.6%) have been reported from 27 out of 114 districts in the country. Of these, 277 cases (71.6%) had the pneumonic form of the disease, 106 were bubonic plague, one case was septicaemic plague, and 3 cases were unspecified. Of 279 cases reported to the Central Plague Laboratory of the Institut Pasteur of Madagascar, 38 were confirmed by polymerase chain reaction (PCR), 113 were classified as probable cases after testing positive on rapid diagnostic tests (RDT) and 123 remain suspected cases, pending results. Fourteen (64%) out of 22 regions in the country (including the North and South-east Regions that are considered non-endemic) have been affected. At least eight healthcare workers from one district health hospital have contracted plague since 30 September 2017.

    Plague is known to be endemic on the Plateaux of Madagascar (including Ankazobe District where the current outbreak originated) and a seasonal upsurge (predominantly the bubonic form) usually occurs early every year between September and April. Unlike the usual endemic pattern, the plague season begun early this year, and the current outbreak has affected major urban centres, including Antananarivo (the capital city) and Toamasina (the port city).

    There are three forms of plague, depending on the route of infection: bubonic, septicaemic and pneumonic (for more information, see the link http://www.who.int/mediacentre/factsheets/fs267/en/).


    Source:   https://reliefweb.int/report/madagascar/plague-outbreak-madagascar-external-situation-report-02-9-october-2017

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 11 2017 at 6:46am
    Frankly, the following article is alarmist!  But despite that it does make a valid point about nationally funded healthh programs 

    Black Death plague latest: Outbreak ‘SPREADING FAST’ and could hit USA – shock warning

    AN OUTBREAK of pneumonic plague - commonly known as the Black Death - has killed at least 45 people and could become an epidemic in the United States, experts have warned.

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote LCfromFL Quote  Post ReplyReply Direct Link To This Post Posted: October 11 2017 at 9:31am

    "...The outbreak is worrisome because a majority of the confirmed illnesses include cases of the pneumonic plague, which can be transmitted through the air when an infected person coughs, and is 100 percent fatal if left untreated."
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    Seychelles reports plague case linked to Madagascar outbreak

    OHANNESBURG — Oct 12, 2017, 5:22 AM ET

    Authorities in Seychelles say a man was diagnosed with pneumonic plague after returning from Madagascar, where a plague outbreak has killed dozens of people.

    The Seychelles News Agency reported Wednesday that the patient arrived on the main island of Mahe on an Air Seychelles flight on Oct. 6. The airline has since suspended its Madagascar flights.

    The agency says Seychelles health officials are monitoring 258 people, including passengers and crew from the flight carrying the man who fell ill, as well as his family members and patients at a health center where he went.

    Those who died in Madagascar include a basketball coach from Seychelles who was participating in a tournament in the capital, Antananarivo. The outbreak began after a plague death in Madagascar's central highlands in late August.

    Source:   http://abcnews.go.com/Health/wireStory/seychelles-reports-plague-case-linked-madagascar-outbreak-50431993

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 12 2017 at 8:14am

    NICD: SA HAS PLANS IN PLACE FOR PNEUMONIC PLAGUE OUTBREAK

    More than 340 people have been infected and 42 have died following an outbreak of the disease in Madagascar.


    Source and full article:   http://ewn.co.za/2017/10/12/nicd-sa-has-plans-in-place-for-pneumonic-plague-outbreak

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    Plague outbreak - Madagascar - External Situation Report 03 -12 October 2017

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Loribearme Quote  Post ReplyReply Direct Link To This Post Posted: October 14 2017 at 10:36am
    Time to get the colloidal silver going again. It's great at being an antibiotic.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 16 2017 at 8:53am

    In Madagascar, plague outbreak now threatens largest cities

    By Associated Press

    PUBLISHED: 11:19, 16 October 2017 UPDATED: 14:24, 16 October 2017


    ANTANANARIVO, Madagascar (AP) - As plague cases rose last week in Madagascar's capital, many city dwellers panicked. They waited in long lines for antibiotics at pharmacies and reached through bus windows to buy masks from street vendors. Schools have been canceled, and public gatherings are banned.


    The plague outbreak has killed 63 people in the Indian Ocean island nation, Madagascar's government says. For the first time, the disease long seen in the country's remote areas is largely concentrated in its two largest cities, Antananarivo and Toamasina.


    Global health officials have responded quickly. The World Health Organization, criticized for its slow response to the 2014 Ebola epidemic in West Africa, has released $1.5 million and sent plague specialists and epidemiologists. The Red Cross is sending its first-ever plague treatment center to Madagascar.


    In this photo taken Tuesday Oct. 10, 2017, a girl wears a face mask inside a hospital in the capital Antananarivo, Madagascar.  A plague outbreak has brought some panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation.  (AP Photo/Alexander Joe)mail.co.uk/wires/ap/article-4984586/In-Madagascar-plague-outbreak-threatens-largest-cities.html

    +3

    In this photo taken Tuesday Oct. 10, 2017, a girl wears a face mask inside a hospital in the capital Antananarivo, Madagascar. A plague outbreak has brought some panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation. (AP Photo/Alexander Joe)

    On Wednesday, Madagascar's minister of public health rallied doctors and paramedics in a packed auditorium at the country's main hospital, saying they're not allowed to go on vacation.

    "Let's be strong, because it's only us. We're at the front, like the military," Mamy Lalatiana Andriamanarivo said. The outbreak could continue until the end of infection season in April, experts warn.

    Madagascar has about 400 plague cases per year, or more than half of the world's total, according to a 2016 World Health Organization report. Usually, they are cases of bubonic plague in the rural highlands. Bubonic plague is carried by rats and spread to humans through flea bites. It is fatal about the half the time, if untreated.


    Most of the cases in the current outbreak are pneumonic plague, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. In some cases, it can kill within 24 hours. Like the bubonic form, it can be treated with common antibiotics if caught in time.


    The WHO calls plague a "disease of poverty" caused in part by unsanitary living conditions. Madagascar has a per capita GDP of about $400, and national programs to control the disease have been "hampered by operational and management difficulties," according to a report by the European Centre for Disease Prevention and Control.


    But the airborne pneumonic plague, which accounts for about 75 percent of cases in the current outbreak, makes no class distinctions.

    "Normally, the people who catch the plague are dirty people who live in poor areas, but in this case we find the well-to-do, the directors, the professors, people in every place in society, catching the disease," said Dr. Manitra Rakotoarivony, Madagascar's director of health promotion.


    The current outbreak began in August, earlier than usual, when a 31-year-old man who had spent time in a village in the central highlands, Ankazobe, traveled by bush taxi to the east coast, unaware that he had the plague. He died en route and was buried without any safety precautions in Toamasina. Four people in contact with him also died.

    Residents of the capital began to relax in recent days amid the global response to the outbreak, but the disease remains a serious threat with the number of new cases per day remaining steady.


    Madagascar has fought the disease for more than a century. It was introduced to the island in 1898 when steamships from India brought rats infected with the bacteria that causes the disease. The plague nearly disappeared from Madagascar for 60 years, starting in 1930, but re-emerged in recent decades.


    The black rats that carry the disease in the highlands have gradually developed resistance to it. Unsafe burial practices that involve touching corpses are another reason the disease spreads, according to a 2015 study by scientists at the Pasteur Institute in Madagascar.


    The outbreak has alarmed neighboring countries. A 34-year-old man in another Indian Ocean island nation, the Seychelles, contracted the pneumonic plague while in Madagascar. He was treated in his own country and no longer has symptoms.

    It was the first-ever plague case in the Seychelles, said the country's public health commissioner, Dr. Jude Gedeon. Another Seychellois, a 49-year-old basketball coach, died of the plague last month while in Antananarivo for a tournament.

    Seychelles authorities have established a plague isolation ward and announced that schools will be closed through Tuesday. Foreign travelers who have recently visited Madagascar are not being allowed into the country.

    While the WHO says the risk of the epidemic spreading beyond the region is very low and does not advise restrictions on travel to Madagascar, Air Seychelles has canceled all flights to and from the island until further notice.

    "The situation is still not under control in Madagascar," Gedeon said.

    In this photo taken Tuesday Oct. 10, 2017, a child wears a face mask inside a hospital in the capital Antananarivo, Madagascar. A plague outbreak has brought panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation.  (AP Photo/Alexander Joe)
    +3

    In this photo taken Tuesday Oct. 10, 2017, a child wears a face mask inside a hospital in the capital Antananarivo, Madagascar. A plague outbreak has brought panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation. (AP Photo/Alexander Joe)

    In this photo taken Tuesday Oct. 10, 2017, a member of staff at a school in Antananarivo sprays against plague in a classroom at a school in the capital Antananarivo, Madagascar, as schools remain shut due the outbreak. A plague outbreak has brought panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation. (AP Photo/Alexander Joe)

    In this photo taken Tuesday Oct. 10, 2017, a member of staff at a school in Antananarivo sprays against plague in a classroom at a school in the capital Antananarivo, Madagascar, as schools remain shut due the outbreak. A plague outbreak has brought panic to the city dwellers with schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation. (AP Photo/Alexander Joe)

    on Facebookh schools closed and public gatherings banned as the death toll still mounts in the Indian Ocean island nation. (AP Photo/Alexander Joe)



    Source:   https:///www.dailymail.co.uk/wires/ap/article-4984586/In-Madagascar-plague-outbreak-threatens-largest-cities.html
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 16 2017 at 1:54pm
    Hmmm......  One article says this:

    Pneumonic plague cases top 500 in Madagascar outbreak. Source: http://outbreaknewstoday.com/pneumonic-plague-cases-top-500-madagascar-outbreak-11163/  and one site says this:

    Plague cases near 700 in Madagascar, testing shows sensitivity to antibiotics.  Source:http://outbreaknewstoday.com/plague-cases-near-700-madagascar-testing-shows-sensitivity-antibiotics-38765/


    I could guess that one number was suspected cases and the other confirmed, or one was the total and the other omitted those who had recovered/died.  But then again someone could just be lying - I wonder which one.
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    Still growing,  Todays news:



    Latest update : 2017-10-17

    A plague outbreak in Madagascar has killed at least 74 people and 805 cases have been reported so far. The government has deployed resources to curb the disease, but many obstacles remain.

    As plague cases rose last week in Madagascar's capital, many city dwellers panicked. They waited in long lines for antibiotics at pharmacies and reached through bus windows to buy masks from street vendors. Schools have been canceled, and public gatherings are banned.

    For the first time, the disease long seen in the country's remote areas is largely concentrated in its two largest cities, Antananarivo and Toamasina.

    Global health officials have responded quickly. The World Health Organisation, criticised for its slow response to the 2014 Ebola epidemic in West Africa, has released $1.5 million and sent plague specialists and epidemiologists. The Red Cross is sending its first-ever plague treatment centre to Madagascar.

    On Wednesday, Madagascar's minister of public health rallied doctors and paramedics in a packed auditorium at the country's main hospital, saying they're not allowed to go on vacation.

    'We're at the front, like the military'

    "Let's be strong, because it's only us. We're at the front, like the military," Mamy Lalatiana Andriamanarivo said. The outbreak could continue until the end of infection season in April, experts warn.

    Madagascar has about 400 plague cases per year, or more than half of the world's total, according to a 2016 World Health Organisation report. Usually, they are cases of bubonic plague in the rural highlands. Bubonic plague is carried by rats and spread to humans through flea bites. It is fatal about the half the time, if untreated.

    Most of the cases in the current outbreak are pneumonic plague, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. In some cases, it can kill within 24 hours. Like the bubonic form, it can be treated with common antibiotics if caught in time.

    A 'disease of poverty'

    The WHO calls plague a "disease of poverty" caused in part by unsanitary living conditions. Madagascar has a per capita GDP of about $400, and national programs to control the disease have been "hampered by operational and management difficulties", according to a report by the European Centre for Disease Prevention and Control.

    But the airborne pneumonic plague, which accounts for about 75 percent of cases in the current outbreak, makes no class distinctions.

    "Normally, the people who catch the plague are dirty people who live in poor areas, but in this case we find the well-to-do, the directors, the professors, people in every place in society, catching the disease," said Dr. Manitra Rakotoarivony, Madagascar's director of health promotion.

    The current outbreak began in August, earlier than usual, when a 31-year-old man who had spent time in a village in the central highlands, Ankazobe, travelled by bush taxi to the east coast, unaware that he had the plague. He died en route and was buried without any safety precautions in Toamasina. Four people in contact with him also died.

    Residents of the capital began to relax in recent days amid the global response to the outbreak, but the disease remains a serious threat with the number of new cases per day remaining steady.

    Madagascar has fought the disease for more than a century. It was introduced to the island in 1898 when steamships from India brought rats infected with the bacteria that causes the disease. The plague nearly disappeared from Madagascar for 60 years, starting in 1930, but re-emerged in recent decades.

    The black rats that carry the disease in the highlands have gradually developed resistance to it. Unsafe burial practices that involve touching corpses are another reason the disease spreads, according to a 2015 study by scientists at the Pasteur Institute in Madagascar.

    Outbreak has alarmed neighbouring countries

    The outbreak has alarmed neighbouring countries. A 34-year-old man in another Indian Ocean island nation, the Seychelles, contracted the pneumonic plague while in Madagascar. He was treated in his own country and no longer has symptoms.

    It was the first-ever plague case in the Seychelles, said the country's public health commissioner, Dr. Jude Gedeon. Another Seychellois, a 49-year-old basketball coach, died of the plague last month while in Antananarivo for a tournament.

    Seychelles authorities have established a plague isolation ward and announced that schools will be closed through Tuesday. Foreign travelers who have recently visited Madagascar are not being allowed into the country.

    While the WHO says the risk of the epidemic spreading beyond the region is very low and does not advise restrictions on travel to Madagascar, Air Seychelles has canceled all flights to and from the island until further notice.

    "The situation is still not under control in Madagascar," Gedeon said.


    Source:  http://www.france24.com/en/20171017-madagascar-plague-seychelles-health-disease

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    http://www.zerohedge.com/news/2017-10-18/57-dead-over-680-infected-madagascar-plague-outbreak-escalates

    With the ease of spreading the plague, the likelihood that this disease will move to other more densely populated regions of the planet has become a huge concern for many.

    So far, the plague has claimed 57 lives and infected more than 680 others. These figures are from October 12, however, and the disease is spreading rapidly. An estimated 329 of these cases and 25 of the deaths were in the capital city of Antananarivo. Of the 684 cases reported as of October 12, 474 were the pneumonic plague, 156 bubonic and 1 septicemic plague. A further 54 were unspecified, according to the World Health Organization. Of Madagascar’s 114 districts, 35 have reported cases of plague, including at least 10 cities.

    -

    Internationally, this outbreak is also being taken seriously. WHO delivered more than 1.2 million doses of antibiotics and released $1.5 million in emergency funds earlier this month. The Red Cross has released more than $1 million to deploy a treatment center and has mobilized more than 1,000 volunteers and is upgrading their skills on community surveillance, finding and monitoring people who have been in contact with infected patients and insightful messaging to stop the spread of this disease.

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 18 2017 at 5:01pm

    Madagascar: Plague outbreak kills 74 as of October 17 /update 7


    8 Oct 10:59 PM UTC

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 18 2017 at 5:30pm

    How the Plague Outbreak in Madagascar Got So Bad, So Fast


    October 18, 2017 05:35pm ET


    The death toll from a recent plague outbreak in Madagascar is rising, according to news reports.

    The country's main agency responsible for tracking the disease, theInstitut Pasteur de Madagascar (the Pasteur Institute of Madagascar), says the current outbreak, which began in August, has resulted in 805 cases of plague, causing at least 74 deaths, as of Oct. 16. (The latest report from the World Health Organization (WHO) from Oct. 12 places the death toll at 57 out of 684 cases.)

    Plague in Madagascar isn't new; the WHO estimates that, on average, there are about 400 cases of bubonic plague (the more common form of the disease) in the country annually. But the number of cases and deaths in the current outbreak has exceeded health officials' estimates. So, what's different this year? And how can the outbreak be stopped? [27 Devastating Infectious Diseases]


    One reason the plague that's spreading in Madagascar this year is so deadly is that the disease is spreading in its "pneumonic" form. Unlike the more common bubonic plague, which is spread from rats and fleas to humans, the pneumonic plague can spread from human to human, said Dr. Peter Small, an infectious-disease specialist and director of the Global Health Institute at Stony Brook University in New York.

    Both forms of the plague are caused by the bacterium Yersinia pestis, which lives in fleas and rats. When the plague-causing bacteria get into a person's blood from a fleabite, it can travel to the lymph nodes. These lymph nodes become inflamed; in this form, they're called "buboes," which is how the bubonic plague gets its name. Along with inflamed lymph nodes, the plague causes symptoms similar to those of malaria or the flu, such as fever, chills and nausea.

    The pneumonic plague develops when bubonic plague goes untreated and the infection moves from the lymph nodes into the lungs, Small told Live Science. Once in the lungs, the bacteria can be expelled into the air in suspended particles. There, it can live for more than a day, Small said. Madagascar is used to dealing with the bubonic form, which doesn’t move human to human, said Small, so the high rate of pneumonic plague in this outbreak (about 65 percent of cases thus far) has made it particularly severe.

    "If anyone has pneumonic plague, everyone else is at risk," Small said.

    Indeed, this airborne form of the plague can be deadly in as little as 24 hours after symptoms begin, said Lila Rahalison, a microbiologist in the division of global health protection at the Centers for Disease Control and Prevention.

    Crowded conditions

    Rahalison told Live Science that the current outbreak in Madagascar was also spurred by another factor: Patient zero — the first patient identified in the outbreak— fell ill while traveling toward the country's crowded capital city, Antananarivo. The patient, a 31-year-old man, started having malaria-like symptoms on Aug. 23, according to the WHO. Four days later, he started coughing and then died while traveling on a small, packed bus, WHO officials said. By the time the outbreak was detected, on Sept. 11, all of the people patient zero had infected had traveled to Antananarivo and beyond. Plague cases are now present in 35 of the 114 districts in Madagascar, according to the WHO. [5 Most Likely Real-Life Contagions]

    The easy transmission of the disease and high population density in the capital led the disease to spread more quickly, Rahalison said. To slow the current outbreak, it's vital to control the spread of the plague and get lifesaving antibiotics to afflicted regions as fast as possible is vital, she said.

    But these tasks can be challenging in a country like Madagascar, experts say.

    "For a health care system with [few] resources, it’s hard to adapt to such a rapidly developing disease," said Dr. Simon Grandjean Lapierre, an infectious-disease specialist and medical microbiologist also at Stony Brook University. Pneumonic plague is fatal unless patients are treated with antibiotics, he added.

    The government has shut down most of the country and stopped travel in an effort to contain the spread of the disease, Grandjean Lapierre told Live Science.

    But in the Ranomafana National Park and Antananarivo, where Grandjean Lapierre conducts his research in Madagascar, most of the population doesn't seem very worried, possibly because the community hasn't internalized the increased dangers of the pneumonic plague versus the bubonic form, he said.

    Moreover, "the Malagasy people are still shamed about the plague," said Rahalison, who is originally from Madagascar. "There is a stigma around it. For people, it's linked to the rats; rats are linked to dirt and poverty. So it's [a] difficult situation." Rahalison worries that this shame encourages sick people to hide — something she's encountered while working with the WHO in Madagascar.

    "Now, we need a very fast response," Rahalison said. "It’s critical that the outbreak be contained as soon as possible."

    Originally published on Live Science.

    Source:  https:///www.livescience.com/60715-plague-outbreak-madagascar.html

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 19 2017 at 3:35am

    Plague outbreak - Madagascar - External Situation Report 04 - 17 October 2017


     
    Published on 18 Oct 2017

    1. Situation update

    Madagascar is experiencing a large outbreak of plague affecting major cities and other non-endemic areas since August 2017. Between 1 August and 15 October 2017, a total of 849 cases (suspected, probable and confirmed) including 67 deaths (case fatality rate 7.9%) have been reported from 37 (32.5%) out of 114 districts in the country. Of these, 568 cases (67%) were clinically classified as pneumonic plague, 155 (18.3%) were bubonic plague, one case was septicaemic plague, and 125 cases were unspecified. At least 39 healthcare workers have contracted plague since the beginning of the outbreak.

    Of the 849 reported cases, 78 (9.2%) were confirmed, 304 (35.8%) were classified as probable after testing positive on rapid diagnostic tests (RDT) and 467 (55%) remain suspected. Eleven strains of Yersinia pestis have been isolated and were sensitive to antibiotics recommended by the National Program for the Control of Plague.

    Eighteen (81.2%) out of 22 regions in the country, including traditionally non-endemic areas, have been affected. The district of Antananarivo Renivohitra has been the most affected, accounting for 57.1% of the reported cases. As of 16 October 2017, a total of 3745 contacts were identified, 79.2% (2 967) of them were followed up on the day of reporting.

    Plague is endemic on the Plateaux of Madagascar, including Ankazobe District where the current outbreak originated. There is a seasonal upsurge, predominantly of the bubonic form, which occurs every year, usually between September and April. The plague season began earlier this year and the current outbreak is predominantly pneumonic and is affecting non-endemic areas including major urban centres such as Antananarivo (the capital city) and Toamasina (the port city).

    There are three forms of plague, depending on the route of infection: bubonic, septicaemic and pneumonic (for more information, see the link http://www.who.int/mediacentre/factsheets/fs267/en/).


    Source:   https:///reliefweb.int/report/madagascar/plague-outbreak-madagascar-external-situation-report-04-17-october-2017


    The highlights were added by myself. - Technophobe

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 20 2017 at 11:06am

    Red Cross warns stigma could worsen Madagascar plague outbreak

    4 MIN READ

    YAOUNDE (Thomson Reuters Foundation) - The death toll from the plague which is spreading in Madagascar has risen close to 100, and the Red Cross has warned that growing stigma attached to the disease could undermine efforts to contain the outbreak.

    While cases of bubonic plague occur in Madagascar nearly every year, this year’s epidemic is “much more dangerous”, said Elhadj As Sy, secretary general of the International Federation of Red Cross and Red Crescent Societies (IFRC), from Madagascar.

    This year, plague arrived earlier than expected, and has become much more contagious as it is now being transmitted from person to person through the air in its pneumonic form, as well as from animals to humans through infected flea bites in its bubonic form.

    The infection is also spreading in urban centers and in areas that until now had not been affected, the World Health Organization (WHO) said this week.

    IFRC staff on the ground say panic is exacerbating the stigma around the plague, Sy told the Thomson Reuters Foundation.

    There is a risk this could “drive people underground and that may result in us losing some of the contacts we are tracing in order to contain the outbreak”, he warned. “Our volunteers are working in communities convincing people to seek help.”

    The Red Cross is using burial practices that avoid contact with corpses and has opened a plague treatment center to help Madagascar tackle its worst outbreak of the plague this century.

    The latest figures from Madagascar’s health ministry show there have been 911 recorded cases of the plague across 17 of the island nation’s regions since August, killing 95 people so far.

    “The number of cases is growing by the day,” Sy told the Thomson Reuters Foundation, adding that the seriousness of the outbreak requires “great vigilance”.

    The IFRC has introduced the same “safe and dignified” burial methods used in West Africa during the 2014-2016 Ebola epidemic, which are also being followed by the WHO and local government authorities to limit the spread of the plague.

    Experience has shown such practices cut the chain of transmission, by preventing further infections through direct contact with corpses, while enabling families and relatives to bury their dead in line with local customs.

    Hospitals in Madagascar are on high alert and are implementing preventative measures, medical staff said.

    “We are limiting the number of visitors, and stipulating that all the health professionals wear a mask when they meet a patient,” said Mamy Randria, head of the clinic for infectious diseases at the public hospital of Befelatanana in Antananarivo.

    “People are aware of the problem - they know that if you have a fever and have other symptoms, you need to seek medical attention,” he said by phone from Madagascar’s capital.

    The IFRC, WHO and other international agencies are also providing ambulances to ensure patients with suspected cases do not spread the virus by taking crowded buses and taxis.

    Another focus is on improving community surveillance, so as to detect infections earlier.

    Sy said building partnerships and trust at the community level is critical, as well as reinforcing an existing referral system for suspected cases.

    But overcoming the plague will require longer-term assistance, he emphasized – “not just intervening at the peak and then forgetting about it”.


    Source:   https://www.reuters.com/article/us-madagascar-plague-aid/red-cross-warns-stigma-could-worsen-madagascar-plague-outbreak-idUSKBN1CP1ID

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 20 2017 at 12:49pm

    Madagascar’s plague outbreak is spreading at an alarming rate

    By Associated Press

    October 20, 2017 | 2:40pm | Updated

    UNITED NATIONS — The number of plague cases in Madagascar has almost doubled over the last five days and medical experts project the situation will worsen, with 1,000 cases expected every month if funds aren’t rapidly provided, the United Nations said Thursday.

    UN spokesman Stephane Dujarric told reporters that only 26 percent of the $9.5 million needed to combat the outbreak of the often deadly disease has been received.

    Dujarric said UN humanitarian officials in the Indian Ocean island nation reported 1,032 cases as of Wednesday, 67 percent of which were pneumonic plague. He says that “is more serious than the bubonic plague and highly challenging to control.”

    So far, he said, 89 deaths have been counted, including 13 on Tuesday.

    Dujarric said UN officials have strengthened systems to identify contacts of victims, monitor the number of patients at hospitals, transport medical samples and address “the transmission risks of traditional burial practices.”

    Madagascar has about 400 plague cases per year, or more than half the world’s total, according to a 2016 World Health Organization report. Usually, they are cases of bubonic plague in the rural highlands. Bubonic plague is carried by rats and spread to humans through flea bites. It is fatal about half the time if untreated.

    Modal Trigger

    For the first time, though, this outbreak is largely concentrated in the country’s two largest cities, Antananarivo and Toamasina.

    Most of the cases in the current outbreak are pneumonic plague, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. In some cases, it can kill within 24 hours. Like the bubonic form, it can be treated with common antibiotics if caught in time.

    Global health officials have responded quickly.

    The World Health Organization, criticized for its slow response to the 2014 Ebola epidemic in West Africa, has released $1.5 million and sent plague specialists and epidemiologists. The Red Cross is sending its first-ever plague treatment center to Madagascar.

    But, Dujarric said, “Medical experts project that the situation will continue to deteriorate, with 1,000 cases per month expected if the response is not rapidly funded.”

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 22 2017 at 2:33pm

    Madagascar: Plague Outbreak Situation Report, 22 October 2017

    REPORT
    from UN Children's Fund
    Highlights
    • On October 4 the Government launched its response plan, mobilizing community authorities and civil servants, reducing large gatherings, and temporarily closing schools – currently until early November.

    • UNICEF Madagascar is deploying its full resources in support of the Government’s efforts to bring Madagascar’s current plague outbreak under control, working in close collaboration with the World Health Organization (WHO) and other partners. Over the past two weeks, outbreak control efforts have significantly accelerated to facilitate detection of plague cases, access to treatment and tracing of people who have come in close contact with infected individuals.

    • Madagascar experiences annual outbreaks as the plague remains endemic in rural parts of the country, however the current outbreak is particularly concerning due to the predominance of pneumonic plague among confirmed cases - the most dangerous and contagious clinical form of plague, and given the high case load found in urban centres (particularly the capital Antananarivo and the main port Tamatave)

    • As of 19 October, a total of 1,297 plague cases have been notified (among these 131 confirmed, 574 probable and 592 suspected cases), with numbers indicating two concurrent epidemics of pneumonic (human to human transmitted) and bubonic (flea-bite transmitted) plague forms: 846 pneumonic, 270 bubonic, 1 septicemic, 180 nonspecified). Among these, 102 deaths have been recorded and 39 of the country’s 114 districts are affected. The WHO currently rates the outbreak as high risk at national level, medium risk at regional level and low risk at international level.

    • UNICEF has been leading communication efforts to ensure that the population is sufficiently sensitized to report any plague symptoms early and thereby facilitate access to treatment. UNICEF interventions have further focused on supporting Ministry of Health case management and community response interventions, leading WASH interventions in hospitals and care centres, as well as providing support to the Ministry of Education to establish special prevention measures in schools.

    Situation in Numbers

    1,297
    Total cases notified, of which 846 pneumonic plague cases reported in various locations of the country, notably the urban areas of Tamatave, and Antananarivo

    102
    Deaths reported

    39
    Out of 114 districts in Madagascar have been affected with the highest number of cases detected in the capital

    US$ 2.6 million
    Estimated required funding for UNICEF contribution to response

    Situation Overview & Humanitarian Needs

    Madagascar is one of a few countries globally where the plague remains endemic. Plague outbreaks, which occur annually in Madagascar, are usually confined to remote rural areas and triggered by the wide-spread ‘slash and burn’ practice as rats which carry the fleas carrying the bacteria Yersinia pestis move towards habitation locations thereby facilitating human infection through flea bites – resulting in the bubonic form of the plague.

    The current outbreak features two concurrent epidemics: A bubonic plague outbreak and a second epidemic of the highly contagious pneumonic plague, which is spread through human to human transmission - with the majority of the reported cases being pneumonic plague. Of concern is that the majority of this year’s cases are in densely populated urban areas including the capital Antananarivo (3,724,021 population), and the two coastal towns of Tamatave (1,412,021 population) and Mahajunga (889,277 population). The recovery rate from plague infection is excellent if treated rapidly with antibiotics. However, if not diagnosed and treated immediately, death occurs within one-three days.

    Given the annual recurrence of plague outbreaks, Madagascar has in place basic plague control measures and good technical expertise especially via the Institut Pasteur Madagascar. However, due to the overall weak state of the health system and the new dimension with the current outbreak being concentrated in urban centres and the much greater magnitude, the country does not have the capacity to respond to the situation without additional international technical and financial support. The WHO has to date classified the current epidemic as high risk for the country, medium risk for the region, and low risk globally.

    Source:   https:///reliefweb.int/report/madagascar/madagascar-plague-outbreak-situation-report-22-october-2017

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 23 2017 at 8:31am

    Aid group says Madagascar plague outbreak yet to reach peak

    The Associated Press 
    Published Monday, October 23, 2017 10:52AM EDT

    ANTANANARIVO, Madagascar - An international aid group says a deadly outbreak of plague in Madagascar has not yet reached its peak.

    Action Against Hunger said Monday that 102 plague deaths have been reported since the outbreak began in August and that most of the nearly 1,300 reported cases of plague are of the pneumonic kind, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. It says the highest number of cases have been detected in Madagascar's capital, Antananarivo.

    Olivier Le Guillou, the aid group's director in Madagascar, says, "we have not yet reached the peak."

    Plague is endemic in Madagascar. This year's outbreak is unusual because for the first time the disease has affected the Indian Ocean island's two biggest cities, Antananarivo and Toamasina.

    Source:   http:///www.ctvnews.ca/health/aid-group-says-madagascar-plague-outbreak-yet-to-reach-peak-1.3644402


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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 23 2017 at 11:31am

    Plague outbreak deaths rise

    23 October 2017

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    HEALTH

    The Madagascan plague outbreak has killed at least 94 people, with the number infected since August now thought to be around 1,150.

    The recent surge in deaths, and the spread of the disease to major cities, has led authorities to warn travellers to avoid the country. The UK’s Foreign and Commonwealth Office (FCO) has updated its travel advice for UK tourists, stating: “There is currently an outbreak of pneumonic and bubonic plague in Madagascar. Outbreaks of plague tend to be seasonal and occur mainly during the rainy season, with around 500 cases reported annually. Whilst outbreaks are not uncommon in rural areas, the latest outbreak has seen an increase in reported cases in urban areas, including Antananarivo.”

    The FCO also told travellers to make sure that their travel insurance will allow for repatriation from the country or medical treatment abroad in case of infection. Authorities from Australia, Portugal and the UAE have mirrored the FCO’s warnings.

    The World Health Organization (WHO) has clarified that most of the cases reported have been of pneumonic plague, which can be treated with antibiotics in its early stages. It has also stated that it believes the risk of global outbreak is low, and has advised against travel and trade restrictions.

    Source:  https:///www.itij.com/story/13693

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2017 at 2:22am
    This is an article, I believe, published just so the headline can catch your eye.  But, here it is antway for those interested:

    Plague symptoms: Signs you could have DEADLY Black Death after Madagascar outbreak

    THE PLAGUE has killed almost 100 people in Madagascar. These are the signs and symptoms to watch out for if you’re travelling to the southeast African island.

    1

    Plague quarantine MadagascarGETTY Images

    Plague symptoms include fever, body aches and vomiting

    There is currently an outbreak of both pneumonic and bubonicplague in Madagascar, according to The Foreign and Commonwealth Office.

    The plague is an infectious disease that’s spread by a bacteria found in small animals and their fleas.

    Humans can become infected from flea bites, unprotected contact with other infected humans, or by simply breathing near the infected.

    Untreated plague can be deadly, so early treatment with antibiotics is vital, said the World Health Organization (WHO).

    RELATED ARTICLES




    Plague symptoms include sudden fevers, head and body aches, vomiting and nausea.

    Bubonic plague - the most common form of plague - can causes inflamed lymph nodes, making them tense and painful.

    As the condition worsens, the lymph nodes can turn into pussy, open sores.

    The bubonic plague is transmitted to humans by infected fleas.

    Plague preventionGETTY Images

    Avoiding flea bites and contact with infected humans was the best way to prevent contracting plague

    Pneumonic plague is usually caused by bubonic plague spreading into the lungs.

    It’s the most contagious form of the plague, and can be spread by coming into contact with respiratory droplets from infected humans.

    Symptoms of pneumonic plague includes bloody or pussy saliva, chest pain and coughing. It can also lead to organ failure and shock.

    Without treatment, patients could die within 18 hours.

    Madagascar


    Source:   http://www.express.co.uk/life-style/health/870068/Plague-symptoms-Black-Death-Madagascar-outbreak-signs-deadly

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 25 2017 at 12:14pm

    124 dead, nearly 1,200 infected with plague in Madagascar

    By Meera Senthilingam, CNN

    Updated 1424 GMT (2224 HKT) October 25, 2017


    Source, video and full article:   http://edition.cnn.com/2017/10/25/health/madagascar-pneumonic-plague-outbreak/index.html

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 26 2017 at 5:58am

    Plague warning is issued for NINE countries including British tourist hotspots amid fears the outbreak in Madagascar could spread on flights


    • Plague has been affecting Madagascar since August and has killed 124 people

    • Country sees seasonal outbreaks but this one has been especially deadly

    • Now there are fears it could spread to nine nearby countries via air passengers 

    By Chris Pleasance for MailOnline                                PUBLISHED: 22:01, 25 October 2017 UPDATED: 22:05, 25 October 2017

    Nine countries including British holiday hotspots have been issued with plague warnings after an especially deadly outbreak in Madagascar.  Health officials in the Seychelles, South Africa and La Reunion - among others - have been told to be vigilant amid fears plane passengers could spread the disease.  So far 124 people have died and more than 1,000 have been infected in Madagascar, making it one of the island's worst outbreaks in years. 


    The warning comes after a scare in the Seychelles earlier this month when a plane passenger complained of symptoms.  The 34-year-old man was a regular visitor to Madagascar who returned to the country on October 6 before developing symptoms three days later.   He was immediately referred to hospital where he was isolated and treated, the WHO said. It was later found he did not have the disease.


    Of particular concern is the fact that two thirds of cases are the pneumonic variant of the disease, which is spread through the air and can kill within 72 hours of contracting it.  It is more deadly then the bubonic variation of the disease which killed a third of Europe's population in the 1300s.  
    Madagascar sees regular outbreaks of the disease, but this one has caused alarm due to how quickly it has spread and a high number of fatalities.   A spokesman for the World Health Organisation said: '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. 

    'Nine countries and overseas territories have been identified as priority countries in the African region for plague preparedness and readiness by virtue of having trade and travel links to Madagascar.  'These countries and overseas territories include Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania.'   WHO has delivered 1.2 million doses of antibiotics to fight the disease while the Red Cross has been training hundreds of volunteers on the island to publicise preventative measures.


    The disease is typically curable if antibiotics are administered quickly. 


    A Foreign Office spokesman said: 'There is currently an outbreak of pneumonic and bubonic plague in Madagascar.'   Outbreaks of plague tend to be seasonal and occur mainly during the rainy season, with around 500 cases reported annually.  Whilst outbreaks are not uncommon in rural areas, the latest outbreak has seen an increase in reported cases in urban areas, including Antananarivo.'  


    Madagascar, off the coast of Africa, is a popular destination for British and European travellers. 





    The UK's other semi-tabloid newspaper has a nrticle on this as well which includes a map of the plague spread so far.  Here:   http://www.express.co.uk/news/world/871060/plague-black-death-madagascar-map-world-health-organisation-bubonic-deat
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    BLACK DEATH SPIRAL 

    Brits leaving plague-ravaged Madagascar face QUARANTINE amid fears black death could become ‘uncontrollable’

    The strict quarantine measures have been introduced to neighbouring tourist hotspot the Seychelles in a bid to prevent the disease going international.

    Source and the rest of this tabloid article:   https://www.thesun.co.uk/news/4771027/plague-black-death-madagascar-uk-quarantine/

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2017 at 4:00am
    Who has just released extra funds to combat this and marburg
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 01 2017 at 2:21am
    They getting very worried about this spending to the African mainland,

    The "Black death" is back.....
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 01 2017 at 2:25am
    Got to admit ,I wasn't taking much notice of this, as I thought it was bubonic,now
    i realise it's pneumonic,well that's very scary indeed
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 01 2017 at 4:14am

    Madagascar: Plague Outbreak Situation Report, 30 October 2017

    REPORT
    from UN Children's Fund
    Published on 30 Oct 2017

    Highlights

    • The number of new notified cases have begun to decline following six weeks of intensive outbreak response by the Madagascar Government and partners to the dual epidemics of pneumonic and bubonic plague. While the number of patients decrease, 978 people have been cured, 122 are currently on treatment, and 113 deaths have been reported.

    • Between 1 August and 27 October, a total of 1,554 cases have been notified, out of which 985 are pneumonic plague, 230 bubonic plague and 339 unknown. Out of these total reported cases, 332 cases are confirmed, 495 cases are probable and 727 cases suspected. It is noteworthy that only 27 per cent of pneumonic cases have been confirmed so far, while 34 per cent remaining probable and 35 per cent suspect. Considering the current situation and the fact that the plague season in Madagascar runs through April, continued vigilance of the response is required.

    • Treatment and referral capacity, data management, contact tracing and communication and sensitization have been significantly reinforced. The current focus is on rumour management, addressing stigmatization, safe and respectful burial, and clarify diagnosis of very young children who are unable to go through regular testing.

    • To facilitate the reopening of schools and the return to school for 415,000 children in affected areas, on November 6 (following the precautionary closure of schools on 2 October), UNICEF has been working with the Ministry of Education on plague detection and referral protocol and related special training for more than 15,000 teachers and administrative staff to ensure that children with symptoms are properly referred to treatment centres without causing stigmatization or panic.

    • UNICEF’s support to the response, is focused on improving the health case management in treatment centres, including hygiene and wash provisions; facilitating food provision for patients and families in hospitals and a continuously evolving communication response aimed at sensitizing communities on the dangers of the epidemic; advice on how to prevent and access treatment, as well as address rumours; reduce stigma and facilitate work at community level (tracing, referral, burials).

    SITUATION IN NUMBERS

    Data as of 27 October

    • 1,554 Total cases notified, of which 985 cases of pneumonic plague, 230 cases of bubonic plague and 339 unknown cases, notably in the urban areas of Tamatave and Antananarivo

    • 978 Recoveries

    • 113 Deaths reported

    • 40 out of 114 districts have been affected with the highest number of cases detected in the capital

    Estimated required funding for UNICEF contribution to response

    US$ 2.6 million

    Situation Overview & Humanitarian Response Madagascar is experiencing two concurrent outbreaks of plague: a flea-transmitted bubonic plague outbreak that has spread beyond the usual rural areas where the plague is endemic, into new rural, as well as urban areas; and a second highly-contagious human to human transmitted pneumonic plague outbreak which has been spreading rapidly predominantly in the three main urban areas of the country. The number of reported cases has been steadily rising although appears to have tapered somewhat in the past 10 days. To date, 1,554 cases have been reported and the number of deaths recently exceeded 100.

    The response is now in place following intense work over the past few weeks on (1) developing the necessary technical protocols for this unprecedented situation, with WHO leading the epidemiological surveillance, treatment, contact and tracing part of this work and UNICEF leading protocol development for schools, WASH and C4D (including safe and culturally appropriate burials), and (2) setting up previously non-existent treatment and care services at hospitals including antibiotics provision, triage and isolation capacity set up, proper hygiene and waste disposal, training of staff amongst other activities. Nevertheless, several factors continue to make this dual epidemic outbreak very complex to manage:

    • A steadily increasing demand to assist in setting up new treatment centres given the rapid overflow of existing hospitals and the emergence of the outbreak in new areas;

    • The lack of capacity of some existing centres to provide adequate isolation and hygiene;

    • Complexity of data systems, with an over-estimate of “suspected” cases, irregular or incomplete data coming from the peripheral level and a constantly evolving situation

    • Complexity of tracing contacts in urban, often informal, settings • False rumours causing panic and creating dangerous behaviours

    • Strong pressure on Ministry of Education to re-open schools UNICEF is supporting the national response alongside the Ministry of Health, World Health Organization (WHO), National Office for Disaster Prevention and Control (BNGRC), USAID, Government of France, Institut Pasteur, International Federation of the Red Cross, Medecins du Monde, Action contre la Faim and Médecins Sans Frontières (MSF). Significant surge capacity from these international organisations has arrived from abroad in recent weeks.

    Source:   https:///reliefweb.int/report/madagascar/madagascar-plague-outbreak-situation-report-30-october-2017


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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 11 2017 at 1:37pm

    Cruise ship passengers protest after captain skips stops in plague-hit Madagascar




    It began with the captain’s announcement: the luxury cruise ship would not be stopping in Madagascar, a country troubled by a deadly outbreak of plague


    The news came the day after the Costa neoRiviera liner set sail, its passengers expecting to be whisked, over two weeks, to Madagascar’s white sand beaches and to the nearby islands of Mauritius, the Seychelles and Reunion.

    The captain first cancelled one of three Madagascar stops, and later scrapped the other two, including one at the tourist resort of Nosy Be.

    This left the ship with just three stops – on Mauritius, the Seychelles and Reunion – which especially frustrated pa

    To compensate for the cancellations, passengers were offered 150 (US$175), Costa Cruises said in a statement.

    This sparked further outrage among the holidaymakers and led one passenger to call the ship a “floating prison” and organise a protest.

    Passengers refuse to disembark after cruise liner skips one stop in Vietnam

    “Things started heating up; 150 when a major part of the trip is cancelled and a glass of water costs 5?” the passenger, Alain Jan, told Le Parisien.

    Jan, 53, runs a restaurant on Reunion, a French island east of Madagascar. The cruise departed from that island October 26, at the height of an unusually deadly outbreak of pneumonic plague occurring throughout Madagascar.


    Experts think the outbreak began in late August, when a 31-year-old man from the eastern city of Toamasina took a trip inland to Ankazobe, where the plague lives in rodent and flea populations.

    While there, the man came down with malaria-like symptoms. He died in a taxi on the way home, passing through Antananarivo, Madagascar’s capital.

    Passengers on Chinese cruise ship left stranded in South Korea amid cash row

    World Health Organisation officials said some of the cases identified were directly or indirectly linked to the man, which is evidence of person-to-person transmission.

    The outbreak has since infected about 1,800 people and killed at least 127, though WHO officials said there has been a decline in new cases reported since mid-October.


    After the crew’s announcement about the cancelled stops, Jan and a small group of passengers demanded a better response.

    When they did not hear back, they staged a protest in a restaurant on the ship.

    “There were 60 of us clapping our hands to alert other cruise passengers of this scam,” Jan told Le Parisien.


    The protest failed.

    So Jan organised a second one, this time in a cinema as the ship was nearing the Seychelles.

    As the ship docked, the exasperated captain called the local police, the newspaper reported.

    The police chief listened to the passengers’ grievances and the crew’s explanation, then asked the captain whether he wanted to kick anyone off the ship.


    Jan said the captain pointed at him.

    Costa Cruises said it chose to evict Jan because he “made violent protests … not accepting the reason of the change of the itinerary” and had been “disturbing the cruise of many other guests on board”.

    For Jan, being thrown off the vessel was a good thing: he said he and his wife spent two nights at a Seychelles hotel and were then flown home to Reunion at the cruise company’s expense.


    But he still felt bad for the passengers left behind, and went to greet them when the ship arrived at Reunion.

    Some passengers told him “they were treated like cattle”, and they continued to feel ripped off.

    “We were 1,200 on board, of all nationalities,” he told the newspaper. “Chinese passengers paid 10,000 per person for this cruise.”


    Passengers he spoke with were, he said, upset with Costa Cruises, believing the company made a decision to avoid Madagascar before the ship set sail.

    But Costa Cruises insisted every effort was made to stick to the original itinerary.

    Mauritius authorities, the company said, were concerned about the ship stopping in Madagascar then sailing to Mauritius with passengers who might have caught the plague.


    “Should there be a suspected case on board, whilst also considering that passengers had already embarked, the company was forced to refocus its route,” Costa Cruises said in a statement.

    The company said passengers who booked excursions in Madagascar were reimbursed and those who embarked on a Costa neoRivera cruise Thursday were told of the modified itinerary ahead of time.

    This article appeared in the South China Morning Post print edition as: Protest on cruise ship after it skips stops over plague fears
    Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 11 2017 at 1:58pm
    so looks like all nations touring

    now thats a recipe for a BIG disaster

    these people are mad .....

    "i booked to land on Madagascar and spend two weeks on the beach and i DEMAND  i get what i paid for "..............



    they be moaning real bad when they put into isolation for a month on return

    truly the people on this planet need a 

                                                           SLATE WIPER   

    F..Kwits..............
    Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.🖖

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Loribearme Quote  Post ReplyReply Direct Link To This Post Posted: November 11 2017 at 6:30pm
    http://www.express.co.uk/news/world/878395/plague-black-death-madagascar-latest-police-seize-bodies-from-families

    Sharing link.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 11 2017 at 9:44pm

    Black death STAMPEDE: Panic in Madagascar amid plague vaccination FURY

    PARENTS rushed to schools in the Madagascan capital on Friday to collect their children after rumours emerged that students were being forced into having anti-plague vaccinations.

    4

    Madagascar plague: Government battle to stop disease spreading


    <

    Amid growing concerns about the epidemic which is gripping the country and has already claimed more than 140 lives, parents were left outraged after rumours emerged that their children were being given vaccinations without their consent.

    According to The Madagascar Express, they rushed to schools across the capital to collect their children after word spread that health officials had arrived with police officers in order to administer the vaccinations.

    While plague is very treatable nowadays, health officials claim there is no efficient vaccine against the plague and the World Health Organisation (WHO) advises against administering vaccinations.

    The plague factsheet on the WHO website reads: “WHO does not recommend vaccination, expect for high-risk groups (such as laboratory personnel who are constantly exposed to the risk of contamination, and health care workers).”




    GETTY•EXPRESS

    A health official implements a desinsectisation as the plague outbreak sweeps through Madagascar

    According to the Madagascar Express, stones were pelted at teachers and furniture was strewn everywhere as furious parents rushed to collect their children, concerned about the validity of these vaccinations.

    One parent allegedly exclaimed: "Are you trying to kill my child or what?”

    The director of the CEG Antanimbarinandriana school, Lantoarisoa Ravololomanana, told the parents: “I want to reassure parents that I will not be plotting with so-called plague vaccinators, to endanger the lives of my children. I, too, have two children here.

    The Ministry of Public Health has also stated that there is no vaccination against the plague and that people who present themselves as vaccinators are impostors.


    GETTY

    Schools are a priority for desinsectisation

    Local media is reporting a sharp drop in school attendance as Madagascar tackles its “worst outbreak in 50 years”.

    Almost 2,000 cases have been reported since the Madagascan outbreak began in early August, with 143 deaths confirmed.

    Of the 1,947 cases, 1,437 were classified as pneumonic plague, 295 were bubonic plague, one was septicemic, and 211 have not yet been classified. 

    Officials say the number of reported pneumonic cases in Madagascar is slowly declining - although more cases of plague are expected as the country enters peak epidemic season, which is due to last until April.

    However, this year’s Madagascar outbreak has been particularly rife and spread far quicker than normal.

    Dr Tim Jagatic, a doctor with Medicins Sans Frontieres (Doctors Without Borders), told Express.co.uk about the cause of this year’s shocking outbreak.

    He said: “From November until April, there tends to be an outbreak of an average of 400 cases of bubonic plague per year.

    “But what happened this year is it looks like there was a case which happened a little bit earlier, in the month of August.

    “If a bubonic case goes untreated, it has the ability to transform into the pneumonic form.

    “It seems as though somebody who had the bubonic form didn’t get treatment, allowing the plague to transform into the pneumonic form.

    EXPRESS

    Ten nearby countries are now on alert as the plague threatens to cross international borders

    “He entered the capital city and then fell sick on a bus that was travelling to Toamasina, and a medical student tried to help him.

    “The medical student came into close contact with him and because it was the pneumonic form of the disease, happening earlier than its expected to in a part of the country where it typically doesn’t occur, it went unnoticed for a particular amount of time which allowed the disease to proliferate.”

    Dr Jagatic added: “A very important part of epidemiology is trying to find who or what was ‘patient zero’, so that we’ll be able to track exactly how it spread, what dangers it poses, who was in contact with that person.

    “Once we find that out, it really helps us to cut the chain of transmission and find out what areas of a country we have to focus our resources on.”

    Comparisons have been made between the Madagascar outbreak this year and the 14th century Black Death, one of the worst plague outbreaks in human history which is widely believed to have caused the world population to shrink from an estimated 450 million down to 350–375 million in the 14th century.


    GETTY

    Rat traps pictured outside a primary school in Antananarivo

    Dr Jagatic revealed why the two epidemics are being compared.

    He said: “There’s a historical stigmatisation – people still use the term ‘Black Death’ which is a term which is associated with the outbreak in the thirteenth century in Europe when 50 million people died.

    “According to the records we’ve seen, it seems as though that name was associated with the disease because a lot of people, in this pre-antibiotic era, were falling into the septic form of the disease.

    “That septic form, as we now know, caused a loss of circulation in the fingertips and when you have a loss of circulation in the fingers they turn black.

    “This disease bore a strong association with sepsis, so every time somebody developed black fingers people expected them to die within the next day or so.”

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 12 2017 at 12:13am
    http://www.zerohedge.com/news/2017-11-11/plague-fears-grow-new-virus-no-cure-appears-worse-black-death Western "media" have finally heard of the plague in Madagascar and combined that story with Marburg in Uganda. Since most "journalists" would not know were to find those countries on a map they create there one unrealistic bla-bla. 

    http://apps.who.int/iris/bitstream/10665/259424/1/Ex-PlagueMadagascar09112017.pdf According to the WHO the plague in Madagascar is on decline, was never a major risk for spreading international. (When you get infected you will be to ill to travel very fast-with hardly any roads, limited travel/tourism not much moves fast in Madagascar.)

    Still the total neglect of good healthcare-it could mean rich people paying tax-is a very major risk for the global healthsituation. An elite spents zillions on weapons and insane oil-wars but is to stupid and ignorent to care about climate change https://www.thethirdpole.net/2017/11/09/climate-summit-deadlocked-over-immediate-action/ or global healthrisks. They get away with it since the mass media is in their hands. "Sensation sells"-solutions don't.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: November 12 2017 at 11:16am
    [

    Still the total neglect of good healthcare-it could mean rich people paying tax-is a very major risk for the global healthsituation. An elite spents zillions on weapons and insane oil-wars but is to stupid and ignorent to care about climate change https://www.thethirdpole.net/2017/11/09/climate-summit-deadlocked-over-immediate-action/ or global healthrisks. They get away with it since the mass media is in their hands. "Sensation sells"-solutions don't.
    [/QUOTE]



    well said DutchJosh
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: November 12 2017 at 10:39pm
    This is very dumb!



    Cadavra crowd surfing! still considered okay by the WHO

    Its about time the WHO-tards started telling the African nations that this practice is not healthy.

    Someones cultural/religious needs can't over ride the world safety.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 13 2017 at 1:32am
    Funeral-insanity was also a major cause of spread of the Ebola-virus during the outbreak in West Africa. https://en.wikipedia.org/wiki/West_African_Ebola_virus_epidemic.

    Human behavior is a major contributing factor to pandemics. In the "third"world (a western term to distance ourselves from the poverty rich countries create) most people only have their feet as means of transport-no cars, no roads, so a virus human-to-human only spreads as far humans can walk. 

    https://en.wikipedia.org/wiki/Halabja_chemical_attack#International_sources_for_technology_and_chemical_precursors During the Iraq-Iran wars-after the "Islamic"revolution in 1979 in Iran-the west supported Saddam Hussein a.o. with chemical weapons. Also in the war for Syria the US supplied "rebels" with Sarin-gas and then blamed the Assad government. 

    http://www.clubconspiracy.com/forum/showthread.php?t=10515, https://www.henrymakow.com/001836.html, https://healthwyze.org/reports/239-proof-that-the-swine-flu-epidemic-was-man-made-and-intentional The 1918 "Spanish Flu" may have been a bio-weapon. (With possible the US, Germany, France, the UK all working on such a weapon). 

    Also Ebola, Marburg, Plague can be used-en tested-as bioweapons. Loking at history I do not doubt several countries are willing to test such bioweapons in Africa. Especially an island lik Madagascar could be used as a testing ground. 
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 13 2017 at 1:39am
    No point in telling them if they will not listen.

    Every time there is a rumor about a vaccination program the parents take their kids out of school to avoid it.  

    You could teach the kids at school about the value of vaccination and then vaccinate the next generation.  But that would be a solution in 30-50 years, when the previous generation dies off; not so useful for such an acute outbreak, but it could be used to sort out the chronic/endemic plague problem.

    Sadly, sometimes ideas fail to change in a whole society until the holders of superstitious beliefs die and so allow the correct information to flourish in the children, or even grandchildren.  Sad but true, we are a pretty dumb species most of the time.
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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 18 2017 at 2:37pm
    Despite our lack of intelect, despite the contrary claims of the tabloid press, it really is calming down.

    Good news: Madagascar hasn’t seen a new plague case in 3 weeks

     Nov 17, 2017, 3:47pm EST

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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Diligent Quote  Post ReplyReply Direct Link To This Post Posted: November 19 2017 at 7:25pm
    Does an individual build even a smidgeon of immunity after contracting plague?

    Hopefully after surviving a first infection.

    I'm thinking, no.

    Team, any input or feedback will be helpful.

    Thank-you.

    Diligent
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