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Plague in Madagascar

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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


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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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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.

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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: 16 hours 29 minutes ago 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: 13 hours 29 minutes ago 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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