Madagascar in panic amid raging “double plague” outbreak; dozens dead

[Disir]

An unusually deadly seasonal outbreak of plague has gripped the island nation of Madagascar. As of Friday, 258 have been sickened and 36 have died just since August, according to Madagascar’s Ministry of Public Health.

To try to stifle the spread, the government has forbidden public gatherings, including sporting events, and schools have closed for insecticide treatments that kill plague-spreading fleas. People have swarmed pharmacies, desperately seeking face masks and any antibiotics they can get. The World Health Organization on Friday announced that it has released $1.5 million in emergency funds and delivered nearly 1.2 million antibiotic doses to help combat the outbreak.

....But this year is different. The disease is spreading not just in rural, agricultural areas; it’s also spreading in cities. As of September 30, the disease had taken hold in 10 cities across the island, including the capital, Antananarivo.

“WHO is concerned that plague could spread further because it is already present in several cities and this is the start of the epidemic season, which usually runs from September to April,” Dr. Charlotte Ndiaye, WHO representative in Madagascar, said in a recent statement.

Twice the fear
It’s also spreading in two different ways—by fleas and by people—which some have dubbed a "double plague." Usually, plague infections arise as bubonic plague, spread by flea bites. In this case—the Black Death scenario—Y. pestis moves from the site of a flea bite on a human to the lymphatic system, taking up residence and inflaming a lymph node. This causes a painful swelling called a bubo, where the infection gets its name. If it’s left untreated, the infection can spread to the blood, causing septicaemic plague, or the lungs, causing pneumonic plague.
Madagascar in panic amid raging “double plague” outbreak; dozens dead

That's horrific.

 

[waltky]

Pneumonic Plague Continues to Spread Rapidly in Madagascar...

Pneumonic Plague Continues to Spread Rapidly in Madagascar
October 20, 2017 — The World Health Organization reports pneumonic plague is continuing to spread at an alarming rate in urban areas of Madagascar and greater effort is needed to bring this deadly disease under control. Latest figures put the number of suspected cases at 1,153, including 94 deaths.

Health agencies are worried at how quickly this disease is spreading so early in Madagascar’s plague season, which runs from September to April. The disease usually infects some 400 people a year. But this year, with six more months to go, the number of suspected cases is nearly three times higher than normal. WHO Regional Emergency Director for Africa, Ibrahima Soce Fall, says the spread of the disease is faster because pneumonic plague, which is transmitted from person to person, has moved from the remote rural areas to congested urban areas. It is mainly found in the capital Antananarivo and the port city of Toamasina.

Children wear face masks at a school in Antananarivo, Madagascar​

Nevertheless, Fall tells VOA he is confident WHO in coordination with the Ministry of Health and other agencies will be able to contain the disease in short order. He says WHO has provided enough antibiotics to treat 5,000 patients and to protect up to 100,000 people who may have been in contact with an infected person. “This can be controlled relatively quickly if we manage to improve the contact tracing as we are doing right now," said Fall. "So, with the teams who are already used to contact tracing and putting all contacts under antibiotic prophylaxis, we can prevent the disease. I am confident that with the strong team we have on the ground, in common with some partners coming and more health workers, we will be able to revert very quickly the trend.”

Fall cautions, though, it will be important to remain vigilant after transmission is over. He notes stopping the transmission of the plague does not mean the risk is gone. He says the virus is still in the country, and while people continue living in poor, unsanitary conditions, the disease is likely to recur.

Pneumonic Plague Continues to Spread Rapidly in Madagascar

See also:

UN: Madagascar Plague Cases Top 1,000 Mark
October 19, 2017 The number of cases of plague in Madagascar has doubled during the past five days, according to the United Nations.

U.N. spokesperson Stephane Dujarric said Thursday as of Wednesday 1,032 cases were reported, 67 percent of which are pneumonic, which is more serious than bubonic plague. So far 89 deaths have been recorded, including 13 on Tuesday. Dujarric said the spread was "highly challenging" to control.

Medical teams in the country have stepped up efforts to combat the spread of the plague, but experts have said the situation will worsen if not rapidly funded. Only 26 percent of the $9.5 million requested has been contributed, Dujarric said.

Face masks are placed on children in Antananarivo, Madagascar, Oct. 3, 2017. Authorities in Madagascar are struggling to contain an outbreak of the plague that so far has killed 89 people.​

Pneumonic plague is a lung infection, transmitted through flea bites or from person to person through droplets in the air when someone coughs or sneezes. A person can die within 48 hours of the disease's onset if not treated with antibiotics. Symptoms of pneumonic plague include coughing, fever, chest pain and difficulty breathing.

While plague is a recurring problem in Madagascar, this particular outbreak has triggered a nationwide panic because it has moved from remote rural areas into the cities, including the capital, Antananarivo.

UN: Madagascar Plague Cases Top 1,000 Mark

 

[waltky]

The plague in Madagascar...

Why plague caught Madagascar unaware
Fri, 03 Nov 2017 - The African country has been battling the worst outbreak in recent times.

Madagascar is facing the worst outbreak of plague in 50 years. There have been more than 1,800 cases and 127 deaths since the start of August, according to new figures. The island off the south-east coast of Africa is used to seeing about 400 cases of mostly bubonic plague in the same rural areas every year. But this year it has developed into the deadlier pneumonic version and spread to much more populated areas, including the capital. The WHO describes the plague as "one of the oldest - and most feared - of all diseases". Historically, plague has been responsible for widespread pandemics with extremely high numbers of deaths. It was known as the Black Death during the 14th Century, killing more than 50 million people across Europe.

Bubonic v pneumonic plague:

* Bubonic plague is spread to humans by the bites of infected fleas that live on small mammals such as rats

* Without treatment, it kills up to two-thirds of those infected

* About one in 10 cases will develop into pneumonic plague, which is almost always fatal if not treated quickly

* Unlike bubonic plague, it spreads much more easily through droplets in the air. So if a sick person coughs very close to you, you could pick it up

Treatment centres have been set up​

The good news is that a simple short course of antibiotics can cure the plague, providing it is given early. The current outbreak in Madagascar is also slowing down, with the number of cases falling in the past couple of weeks. But the World Health Organization is warning further spikes could be on the way. It says "despite the relative ease of treatment, plague's association with the Black Death weighs heavily on the popular conscience - and is regularly cited in media reports and tabloid headlines about outbreaks". So how did this outbreak become the worst in recent times?

The WHO describes the overall risk for the island as "very high".​

Unabated spread

"An outbreak of plague no longer unfolds in the manner portrayed by our history books," said Dr Sylvie Briand, director of WHO's Infectious Hazard Management Department. "Plague is an old disease, but the challenges it poses today are contemporary and fundamentally different from what we had even 40 years ago." The medical charity Medecins Sans Frontieres has been responding to the outbreak in one of the worst hit areas of Tamatave. Dr Tim Jagatic told BBC News the outbreak had spread to populated areas when a man infected with bubonic plague had travelled from the highlands to the capital and then on to the coastal city of Tamatave by bus.

MORE

 

[waltky]

The World Bank has approved an additional $5m (R71m) funding...

R71m to combat deadly plague
5 Nov.`17 - The World Bank has approved an additional $5m (R71m) funding to help Madagascar cope with its plague outbreak.

The World Bank has answered desperate cries from aid workers for emergency funding to tackle the "worst outbreak in 50 yearsamp;". Cases of the plague have shot up by 37% in less than a week, and the most recent statistics show at least 1 800 people are now infected and 127 deaths have been recorded. As of October 27, 1 554 reports have been made, of which 985 cases have been identified as pneumonic plague, 230 cases of bubonic plague, and 339 still unknown. The pneumonic plague is a respiratory infection spread by breathing in airborne droplets and is fatal in almost 100% of cases. The bubonic plague is spread by infected rats via flea bite, and may precede the onset of pneumonic plague. The "truly unprecedentedamp;" outbreak has prompted warnings that it could spread to at least nine nearby countries, namely South Africa, the Seychelles, La Reunion, Mozambique, Tanzania, Kenya, Ethiopia, the Comoros and Mauritius.

Health worker sprays classroom with disinfectant​

Scientists predict that this year's outbreak may escalate, as it is stronger than the traditional bubonic form that results in at least 400 cases every year in Madagascar. Figures show that, if current trends continue, the epidemic could strike a further 20 000 people in just a matter of weeks. Professor Johnjoe McFadden, a molecular geneticist at Surrey University, said the plague was "scaryamp;" and was predominantly a "disease of the pooramp;". He added: "It's a terrible disease. It's broadly caused more deaths of humans than anything else; it's a very deadly pathogen.amp;" It is believed that the pneumonic plague caused the Black Death and approximately 50 million deaths in the 1300s. The World Bank said in a press release that the funds would be used in the Emergency National Response plan.

The plan includes the deployment of personnel to the front line in the affected districts; disinfection and fight against insects; cleaning up of vulnerable areas; and for the purchase of fuel for ambulances. A Malagasy delegation headed by the finances and budget minister, Vonintsalama Andriambololona, had appealed for further financial support to combat the epidemic. "We are pleased that the World Bank has listened to our call. The ministry promises to closely supervise the good management of such resources in order to quickly tame the epidemic,amp;" Andriambololona said. The World Bank country manager in Antananarivo, Coralie Gevers, assured that the new financial support would not affect the availability of other funds for Madagascar's social and infrastructure projects.

R71m to combat deadly plague

 

[EvilCat Breath]

It's freedom baby

http://nypost.com/2017/10/26/madagascar-plague-linked-to-ritual-dance-with-dead-bodies/

 

[anotherlife]

Shouldn't all these numbers be adjusted downwards by factoring in the worldwide birth demographic explosion? If we do that, then the numbers are probably the same as they have always be constantly for centuries.