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Madagascar: 2021 Plague

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  • Madagascar: 2021 Plague


    Madagascar's Pneumonic Plague Turns Deadly
    September 11, 2021 • 10:20 am CDT
    (Precision Vaccinations)

    According to the European Centre for Disease Prevention and Control (ECDC) report issued on September 10, 2021, thirty cases of pneumonic plague have been reported in the Republic of Madagascar.

    Pneumonic plague is one of several forms of plague and is endemic in Madagascar.

    The WHO previously confirmed seven cases have been fatal, all of them in the municipality of Miandrandra.

    Madagascar's last major plague outbreak was in 2017, which resulted in 209 deaths; these were classified as pneumonic plague...

  • #2
    Here is the FluTrackers thread for the 2017 Pneumonic Plague outbreak in Madagascar:

    Madagascar - Plague outbreak 2017-18


    Plague 2021: Scientists Recorded Person-to-Person Transmission of Drug-Resistant Yersinia Pestis

    By Rain Jordan Aug 16, 2021 11:12 PM EDT


    Antimicrobial Resistance

    "A spontaneous point mutation has rendered the [antimicrobial resistance] AMR strain from this epidemic resistant to streptomycin, although it is still susceptible to many other antibiotics, including co-trimoxazole. Fortunately, all 19 instances were treated with co-trimoxazole in addition to streptomycin, and they all lived."

    There has previously been evidence of antimicrobial-resistant plague. For example, in 2017, scientists reported the case of a 16-year-old boy in Madagascar who was infected with Y. pestis bacteria that was discovered to be resistant to eight popular antibiotics, including streptomycin, used to treat the infection. This is the first time, however, that experts have found evidence of person-to-person transfer.



    Another FluTrackers thread:

    Study: Transmission of Antimicrobial Resistant Yersinia pestis During a Pneumonic Plague Outbreak


    Okieman Comment: We often tend to think of Plague as being primarily a major concern from the past since antibiotics can be used to treat it now. But, if a antibiotic resistant strain of Pneumonic Plague arises and gets out of Madagascar during this Covid Pandemic then we may have a world of hurt start up.


    • #3
      Plague appears to be a seasonal thing in Madagascar between September and April. What is concerning to me is Pneumonic Plague spreading at the same time as Covid. Here is the symptoms for Pneumonic Plague:

      With pneumonic plague, the first signs of illness are fever, headache, weakness, and rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery sputum.
      And here is a short description:
      • Pneumonic plague occurs when Y. pestis infects the lungs. This type of plague can spread from person to person through the air. Transmission can take place if someone breathes in aerosolized bacteria, which could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in Y. pestis suspended in respiratory droplets from a person (or animal) with pneumonic plague. Becoming infected in this way usually requires direct and close contact with the ill person or animal. Pneumonic plague may also occur if a person with bubonic or septicemic plague is untreated and the bacteria spread to the lungs.
      Both of these quotes are from this CDC factsheet:


      • #4
        Translation google

        Pulmonary plague: Four deaths including one confirmed case in Ambalavao

        Redaction Midi Madagasikara September 13, 2021

        The plague season has only just started but pulmonary plague has claimed yet another victim in Ambalavao. Within days, the disease killed eight people in two districts.

        The pulmonary plague reappears . One person succumbed to this disease again in Ambalavao district, Haute Matsiatra region, according to the report of the Ministry of Public Health. The Director General of Preventive Medicine (DGMP), Dr Fidy Randriatsarafara, also announced the death of three other people who are none other than relatives of the victim. "They are people from the same family but one of them was confirmed to have died of pulmonary plague," he explained. The circumstances under which the victims contracted the disease remain unclear. With the seven deaths recorded in the municipality of Miandrandra, district of Arivonimamo last month, the number of deceased has thus risen to eight.

        Care . Faced with the increase in deaths linked to the plague, Dr Fidiniaina Randriatsarafara called for vigilance and the prevention of this disease. He urged people who show suspicious signs to go to health centers or hospitals as soon as possible because drug care is free. "Pulmonary plague can be transmitted from person to person via tiny droplets of saliva emitted in the event of a cough, for example, which is why it is always advisable to wear masks and to wash your hands with soap. It manifests itself by a high fever, fatigue, headaches or buboes for bubonic plague ”, he stressed. To break the chain of transmission of this disease, patients are not allowed to seek treatment at home, as was already the case for plague sufferers from Arivonimamo. They cannot return to their homes until the ten days of treatment have been completed. In this period when the plague season coincides with the exhumation ceremonies, vigilance is always in order because this ritual can be a factor of transmission of the plague if ever the exhumed bodies have contracted this disease.

        Narindra rakotobe
        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela


        • #5

          Week 37: 6 - 12 September 2021
          Data as reported by: 17:00; 12 September 2021

          Pneumonic Plague Madagascar

          30 Cases
          7 Death
          23.0% CFR


          Health Authorities in Madagascar received an alert of plague
          on 29 August 2021, from the local administrative authorities of
          Miandrandra, Arivonimamo district, in the Itasy region. The case was
          a 23-year-old male resident of Ankararana village in the Miandrandra
          community. He had an onset of illness on 23 August 2021, and later
          sought medical care at the Miandrandra health center on 29 August
          2021 while presenting with symptoms suggestive of pulmonary
          plague (fever, headache, weakness shortness of breath, chest pain,
          cough, and bloody or watery sputum).

          On 31 August 2021, the preliminary results of the investigation
          showed a total of 30 suspected cases of pulmonary plague,
          including seven deaths (four community deaths and three health
          facility-based), giving a case fatality ratio of 23%. Twenty laboratory
          samples (12 blood and eight sputum) were collected and sent to the
          Pasteur Institute of Madagascar for analysis. Of these 20 samples,
          12 (60%) were PCR positive, confirming the outbreak of pneumonic
          plague in the country.

          The average age of cases is 39.6 years, with a male to female sex
          ratio of 1.1. The peak of suspected cases reported was observed on
          29 August 2021, with 9 cases reported in a single day. A cumulative
          total of 916 contacts have been identified and are currently
          monitored, all of them received chemoprophylaxis.

          All the reported cases were geographically located in three
          communities of Arivonimamo district (Ampahimanga, Manalalondo
          and Miandrandra). Itasy region is a densely populated area and has
          regularly been one of the most affected regions during previous
          plague outbreaks. Arivonimamo district is located at only 51 km
          from Antananarivo, the capital city of the country and traffic is
          intense between those two areas. In 2017, Madagascar faced a
          large-scale pneumonic plague outbreak that affected endemic and
          non-endemic areas, including large urban centers like Antananarivo
          and Toamasina.


          The Ministry of health response team conducted a field
          mission to the affected areas for an in-depth epidemiological
          investigation as well as to support local investigation teams.
          Plague control committees were activated in the affected
          areas. Vector control and anti-reservoir rodent control through
          environmental sanitation activities are underway.

          Management of reported cases at healthcare facilities is

          Collection of specimen samples is ongoing with rapid diagnostic
          tests and shipment of samples to the Pasteur Institute of
          Madagascar for further analysis and confirmation.

          Teams are conducting active case finding, listing contacts and
          administering chemoprophylaxis to high-risk contacts.

          Sensitization of the population on plague prevention measures
          in the affected areas.


          Plague is endemic in Madagascar and cases are reported each
          year in bubonic and pulmonary forms. The annual season for
          increased disease transmission is between September and April
          and an increase in the number of cases is expected in the coming
          weeks. The risk of spread for the current outbreak to other
          areas of the country, especially urban centers, is high, taking
          into account the proximity of the affected areas to the country’s
          capital and the frequent population movement. Though the
          country has experience in managing and coordinating outbreak
          response, having responded to multiple outbreaks in the past,
          the existence of other concurrent health emergencies such as
          COVID-19 and the humanitarian crisis (food and nutrition crisis
          in the great South) in the country hamper the health system’s
          ability to effectively cope with the health challenges being faced
          in the country.


          It is essential that Madagascar builds on good practices that
          led to the successful management of previous outbreaks and
          taking into consideration some key actions recommended then.
          Actions should include early identification and rapid elimination
          of infection sources including vectors, and protecting health
          workers by training them on infection prevention and control
          measures. Health workers who are in direct contact with
          pneumonic plague cases should use recommended protective
          measures and take antibiotic chemoprophylaxis. Surveillance
          activities should be strengthened to identify and monitor new
          cases and contacts. Risk communication and community
          engagement activities should be performed during and after the

          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela