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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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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 05 2017 at 9:54am

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

    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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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 14 2017 at 2:33am

    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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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: October 17 2017 at 9:02am
    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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    Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: October 18 2017 at 1:38pm
    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.

    Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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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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