PlagueMore than 1,300 suspected plague cases reported in Madagascar

The World Health Organization (WHO) reported a total of 1,309 suspected cases, including 93 deaths, in an update 27 October on the plague outbreak in Madagascar. The case-fatality rate for the outbreak is now 7 percent.

The numbers reflect an increase of 12 cases and 9 fewer deaths from the WHO’s previous update on 20 October.

The number of new plague cases continued to decline for the second week in a row, with 12 affected regions reporting no new cases. All suspected cases were reported between 1 August and 24 October, with the majority (882 or 67 percent) confirmed as pneumonic plague, the only type of plague transmitted from person to person. The WHO said as of 24 October, 94 percent of traced case contacts had received prophylactic antibiotics.

A total of 186 suspected cases are unspecified and undergoing further testing. Seventy-one healthcare workers have been infected in this outbreak, but none of those cases have proved fatal.

Plague is endemic in parts of Madagascar, and though the outbreak began with one epidemiologically linked cluster, the WHO warned that the risk at the national level is still “very high.” The risk of international spread, however, is deemed “very low” because of the short incubation period for pneumonic plague.

In other plague news, the European Centre for Disease Prevention and Control (ECDC) released new guidelines for detecting plague on ships and airplanes, and for using personal protective equipment (PPE) in healthcare settings with suspected plague patients.

For traveling, plague should be suspected when a person has traveled from an active outbreak area and reports persistent fever, cough, and trouble breathing. Prophylactic antibiotics may be given to any passengers or crew that came into contact with the person.

Plague patients should be isolated, if possible, in healthcare settings and healthcare workers should wear protective coverings, gloves, and masks.