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Madagascar - Plague outbreak 2017-18

Translation Google

Plague epidemic - Very high spread risk, according to WHO

12.10.2017 | 8:35 News, Alaune, Politics0

According to WHO, the epidemic of plague in Madagascar is to "grade 2". Although the isolation of the Big Island is removed, the risk of spreading national, however, is "very high".

table card. According to the World Health Organization, the epidemic of plague in Madagascar is grade 2. A classification that would involve a risk of spreading national, very high. Information shared during the meeting between the government, the diplomatic corps and the technical and financial partners (TFP) yesterday at Mahazoarivo.

The meeting, which lasted nearly two hours, was to share information between the government and international partners on the development of the disease and devices committed to combat it. The openness and transparency would have been the watchword of the meeting. "We are completely transparent, giving you all the information. There is no reason not to be, "said Henri would Rabary-Njaka, Minister of Foreign Affairs, according to the echoes of the meeting.

That said, Charlotte Ndiaye, WHO representative in Madagascar would have explained to the audience that this international body has classified the epidemic grade 2. This would mean that the risk of spreading pneumonic plague nationally is very high. At the regional level, the risk is moderate and internationally, it is low.

plotting

International partners of the Big Island, the WHO representative would have indicated that, given the level of risk, the International Health Regulations, voted and approved by all countries of the world, would imply that there is no restrictions on flights and the commercial movements in Madagascar, at the entrance and exit. A green light, subject to the application of the WHO health checks.

To reassure their interlocutors, members of the government are in particular struggled to assert respect for these health checks. The head of the Malagasy diplomacy even stressed the descent of the Minister of Health and that of Transport, in Ivato, the night of October 10, to check the strict application of health standards that are needed to fight against the international spread of the epidemic.

"As the WHO has said, the epidemic is level 2. (...) It is at level 3 that the isolation of the country is the most to be feared," said Solonandrasana Olivier Mahafaly, Prime Minister at the end of the meeting. The objective of convincing the donors not to cut ties with Madagascar, as did the Seychelles. A case of plague, however, been reported in the archipelago on Tuesday.

A 34 year old man would have contracted the disease in the Big Island, he would have left before that Seychelles barricading its borders. WHO would have conceded during yesterday's meeting that there would be difficulties in maintaining the epidemic so that it does not get out. The level of risk does not require Madagascar be quarantined. "Grade 2" prescribed by WHO could, however, be less reassuring nationally.

The high risk of national spread is explained by the fact that it would be "difficult to trace and stop the contamination chain." Reported cases appear, in fact, trigger sporadically in about forty locality. The population density in some affected areas as Antananarivo and Toamasina, could be among the parameters confirming the very high risk of spread of pneumonic plague.

Added to this is the questionable hygiene of certain categories of fast food. There are also up-and-goings of people confined in transit. disinfection operations, suspension of combinations or events deemed dangerous in the reported locations of plague and the temporary cessation of course, seem to be enough. Official events, religious cults, or, the evenings are always full. This is all the more, not counting the incivility of the population. The families that hide the sick, or patients who are hiding.

Garry Fabrice Ranaivoson

http://www.lexpressmada.com/blog/ac...-risque de propagation tres eleve selon loms/
 
GENERAL SITUATION OF PLAGUE IN MADAGASCAR

For the whole Grande ?le, 35 Districts were affected by the plague epidemic.
In total, 561 reported cases of plague were recorded, 415 of which were pulmonary,
145 of bubonic forms and another case that is unspecified.


In general, there are 57 deaths with a national case fatality rate of 10.2% (this is
the ratio of the number of deaths to the total number of reported cases).

ACTIVITIES UNDERTAKEN
- A meeting was held yesterday at the Prime Minister's Office in the presence of the partners
humanitarian organizations (WHO, USAID, UNICEF, etc.). It was pointed out that
9.9 million Euros is needed to support the fight against
spread of plague at the country level.

- On October 11, 2017, the USA, through USAID, handed over to the State
Malagasy:
- 8 mobile clinic vehicles (6 for Antananarivo and 2 for Toamasina)
- 2 riposte cars for Toamasina;
- 100,000 masks;
- 180 050 respiratory protection masks;
- 490,600 pairs of gloves;
- 150 000 bottles (150 ml) of water and 300 containers of water.

- Sectoral interventions continue to make their contribution
response to plague (communication, awareness, distribution
posters, etc.). However, the Strategic Coordination Center at
of the BNGRC, recommends defining more specific types of activities.

- The Ministry of Public Health continued disinfection and chemo
prophylaxis in the Districts of Tan? V, Tan? IV and Tan? II, in the
city ​​of Antananarivo.

- A BNGRC team is already in Toamasina to strengthen coordination
intersectoral activities in the Regions of Atsinanana and Analanjirofo.

- Today, the BNGRC plans to deploy three teams to support the
Coordination in the Boeny / Betsiboka Regions, High
Matsiatra / Vainankaratra and Itasy / Bongolava.

- The education sector has disinfected 2,054 schools in
the Regions of Analamanga, Atsinanana, Analanjirofo, Boeny, Itasy, High
Matsiatra and Amoron'i Mania. It also plans to disinsect other
3,720 schools in these regions.

- The next meeting of all stakeholders, every Tuesday and Thursday in
16:00 at the BNGRC;

- Committee meetings each day, followed by a report from the Chiefs of
commission daily and to share with the BNGRC.
 
[h=1]Plague outbreak - Madagascar - External Situation Report 03 -12 October 2017[/h] Report

from World Health Organization Published on 12 Oct 2017 ? View Original


application-pdf.png
Download PDF (1.8 MB)


1. Situation update
The outbreak of plague in Madagascar continues, with an overall reduction in the case fatality rate. On 12 October 2017, 61 new cases and no deaths were reported from six districts. Between 1 August and 12 October 2017, a total of 684 cases (suspected, probable and confirmed) including 57 deaths (case fatality rate 8.3%) have been reported from 35 out of 114 districts in the country. Of these, 474 cases (69.3%) were clinically classified as pneumonic plague, 156 (22.8%) were bubonic plague, one case was septicaemic plague, and 54 cases were unspecified. At least fifteen healthcare workers have contracted plague since the beginning of the outbreak...

Source: https://reliefweb.int/report/madaga...-external-situation-report-03-12-october-2017
 
Translation Google


Health - The epidemic of plague is growing

14.10.2017 | 7:34 News, alaune, Social0

The number of victims of the plague is growing. Six suspected plague patients were buried at the Anjanahary mass grave yesterday.

Overwhelmed. Officers from the municipal office of hygiene (BMH) have scheduled the funeral of six suspected body of plague in the common grave of Anjanahary yesterday. They would all be dead, on Friday 13, a source with the BMH. "Five died in downtown hospitals, three of them in Befelatanana, one in the anti-plague hospital in Ambohimiandra and one in a mother-child hospital. The sixth victim was listed in Manjakaray. She suddenly lost her life on the street, near a bus stop, "the source said. Two of the victims are children. And the man who died in Manjakaray, was returning from a funeral wake. He spat blood, according to testimony.

On 12 October, the hospital Anosiala also recorded a suspected death of plague case. It is a stranger. He was hospitalized for an illness other than the plague, but have already had the bacteria in him, and was tested positive for plague. Last night, another suspected case in Anosiala have also died, according to a local authority.

Brutal

In another hospital of Antananarivo city, Thursday afternoon, people wept bitterly the sudden death of a loved one. They were not expected it. Admitted to another department for another disease, their loved one has been tested positive for the rapid diagnostic test (RDT) of the plague at his death. All these victims were all tested positive for pneumonic plague. "In hospitals, there are protective equipment against infection. Our role is to ensure that no health worker, no sick person or a sick companion is infected, "reassures Mamoudou Harouna Djingarey, Head of Program for Infectious Risk Management in the Organization World health (WHO).

The plague, bubonic or lung, is a disease that can be cured. Since the onset of the epidemic, ninety-seven patients recovered.
The delay treatment at health facilities would be the main cause of these deaths. "When there are worrying symptoms, call the freephone number 910 and wait at home before the arrival of medical teams. Ambulances were placed in all districts for transportation of patients. Self-medication is dangerous, "teaches are we at an orientation and mobilization of journalists at the National Bureau of Risk Management and Disaster (BNGRC) to Antanimora.

Miangaly Ralitera

http://www.lexpressmada.com/blog/actualites/sante-lepidemie-de-la-peste-samplifie/
 
Translation Google

FLASH NEWSLETTER: Center for Study of Reflection Thinking and Orientation 

Madagasikara - EPIDEMIC OF THE PESTE Group Date Time: 14 Oct. 2017 - 17:00

GENERAL SITUATION OF PLAGUE IN MADAGASCAR

The epidemiological situation from 1 August to 13 October 2017 is detailed as follows:

- Total number of cases reported (cumulative for all Madagascar for all this
period and for any type of plague): 610;

- Number of deceased persons (cumulative for all Madagascar for all this
period and for any type of plague): 63;

- National lethality rate: 10.3% (this is the ratio of the number of deaths
total number of notified cases);

Between October 11, 2017 and October 13, 2017, there were 49 cases (cumulative
for all Madagascar for all this period and for any type of plague confused)
including 6 deceased.

It is, however, also important to note that a large number of cases
reported (among the 610 announced therefore) here are either:

- already out of the hospital and cured;
- probable but unconfirmed cases;
- suspected but unconfirmed cases;

...
http://www.bngrc-mid.mg/index.php?o...h-de-la-peste&catid=9:publications&Itemid=112
 
Translation Google

GENERAL SITUATION OF PLAGUE IN MADAGASCAR

The plague epidemic is currently affecting 38 districts,
17 Regions of Madagascar.

Generally, 805 cases of plague were reported, of which 595 were pulmonary and 210
bubonic forms.


The report shows 74 deaths, with a national case fatality rate of 9.2% (the
number of deaths with the total number of reported cases).

Among these notified cases:
- 62 are confirmed according to the results of the Pasteur Institute of Madagascar (IPM);
- 367 are probable according to the rapid diagnostic test (TDR);
- 377 are suspect cases.

(Source: Ministry of Public Health - 16 October 2017)
...

http://www.bngrc-mid.mg/index.php?o...h-de-la-peste&catid=9:publications&Itemid=112
 
Source: https://reliefweb.int/report/madaga...-external-situation-report-04-17-october-2017
[h=1]Plague outbreak - Madagascar - External Situation Report 04 - 17 October 2017[/h] Report

from World Health Organization Published on 18 Oct 2017 ? View Original


application-pdf.png
Download PDF (1.9 MB)


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...
 
Translation Google


THURSDAY 18 OCTOBER 2017: FLASH BULLETIN OF THE PESTS

GENERAL SITUATION OF PLAGUE IN MADAGASCAR

Currently, 39 districts in 17 regions of Madagascar are affected
by the epidemic of plague.

On this day, 911 cases were reported, including: 612 pulmonary forms, 175 forms
bubonic and 124 unspecified.

The general assessment shows: 554 people who are already cured and taken out of the hospital,
262 people in treatment and 95 deaths.
...
http://www.bngrc-mid.mg/index.php?o...h-de-la-peste&catid=9:publications&Itemid=112
 
Translation Google

PLAGUE EPIDEMIC: NOTABLE CHANGE IN THE NUMBER OF CASES CONFIRMED:

Friday, October 20, 2017

The Ministry of Public Health organized a press conference this afternoon on 19 October to inform the population of the current situation of the plague epidemic. The Director of Health Surveillance and Epidemiological Surveillance presented the figures for the last epidemiological situation of 18 October at 11 pm. So since August 1, 2017, 911 cases are reported, 262 are under treatment and 554 people are cured. These figures have been extracted from the graphs showing the number of suspected cases and confirmed cases. These patterns showed a notable change in the number of these latter cases. From 14 October to 17, there were no confirmed cases. The Minister of Public Health Mamy Lalatiana Andriamanarivo said that people consult health centers because they are sensitized, especially by the press. He also revealed that there is no vaccine against plague. He called for multi-sectoral collaboration, especially the Andrimasompokonolona in the fight against this epidemic. Regarding the dignified and secure burial protocol, the head of the Department of Health said that researchers are working with the Malagasy parties so that this protocol can respect the Malagasy culture. The Minister also took advantage of this meeting with the press to mention the number of deaths greater than in previous plague seasons. A considerable number due to the fact that it is Urban Pulmonary Plague. WHO resident representative Charlotte Faty Ndyaie reiterated that there is no drug breakdown and that all partners are present to support the Department of Health in this fight. These include WHO, UNICEF, USAID, French Embassy, M?decins du Monde. The Secretary General, the Director General of Health, the Central Directors and the representatives of the various partners honored the press conference with their presence.

http://www.sante.gov.mg/home/web/blog/1480
 
Translation Google

Epidemic of plague: MSF launches an intervention in Madagascar ?Tamatave, 19 October 2017

On 18 October, M?decins Sans Fronti?res (MSF) began working with local authorities to tackle the plague epidemic in the Tamatave port city of eastern Madagascar.
...
The port city of Tamatave, also known as Toamasina, is home to 300 000 people and is one of the largest outbreaks of cases of pneumonic plague in the country with 261 cases and 10 deaths since the beginning of this epidemic.
...
https://www.msf.fr/presse/communiques/epidemie-peste-msf-lance-intervention-madagascar
 
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.
 
Source: https://reliefweb.int/report/madaga...k-external-situation-report-5-20-october-2017 [h=1]Madagascar Plague Outbreak: External Situation Report #5 - 20 October 2017[/h] Report

from World Health Organization Published on 20 Oct 2017 ? View Original

1. Situation Update
Madagascar has been experiencing a large outbreak of plague affecting major cities and other non-endemic areas since August 2017. Between 1 August and 19 October 2017, a total of 1 297 cases (suspected, probable and confirmed) including 102 deaths (case fatality rate 7.9%) have been reported. Of these, 846 cases (65.2%) were clinically classified as pneumonic plague, 270 (20.8%) were bubonic plague, one case was septicaemic plague, and 180 cases were unspecified (further classification of cases is in process). Of the 846 cases of pulmonary plague, 91 (10.8%) have been confirmed and 407 (48.1%) were probable.
Between 1 August and 15 October 2017, a total of 793 specimens were analysed by the Institut Pasteur de Madagascar (IPM). Of these, 126 (15.9%) have been confirmed either by polymerase chain reaction (PCR) or bacteriological culture, 242 (30.5%) were probable after testing positive on rapid diagnostic tests (RDT) and 425 (53.6%) remain suspected (additional laboratory results are in process). Eleven strains of Yersinia pestis have been isolated and were sensitive to antibiotics recommended by the National Program for the Control of Plague...
 
Translation Google

Epidemic - A Frenchman succumbs to the plague in Toamasina

23.10.2017 | 5:33 News, alaune, Social0

The plague of the lungs was right of a French, long-time resident in Toamasina, this Saturday. The remains have already been buried in a mass grave.

A French forty years bowed out in the Emergency department of the hospital Be Toamasina on Saturday morning, according to a local source. He died from complications of lung plague. "His condition was bad enough when he was admitted to the service. He was unresponsive to treatment, "said Dr. Raymond Rakotoarimanana, Regional Director of Public Health Atsinanana, reached by telephone yesterday. This stranger who lived in Toamasina for years, would have died just a few hours after admission to hospital. His body was already buried in the common grave of the cemetery of Manangareza the same day, to avoid the spread of the disease.

This would not be the first foreigner to have been a victim of this plague in Toamasina, in this season. Dr. Raymond Rakotoarimanana said that there had been another, but that was cured, as received timely treatment. In Antananarivo, the Seychelles and Comoros were among the victims. "The plague can touch everyone. It spreads easily, can kill very quickly, but is treatable when it is supported on time. We must reach a health facility in case of high fever, cough with sputum streaked possibility of blood, fatigue, chills, chest pain, "doctors recommend.

Twelfth death

This is the twelfth plague of death listed in Toamasina, from the beginning of the epidemic, in September. Ten of them have died in sanitary services and two at the community level. The first victims have contracted the bacteria in a bush taxi linking Antananarivo and Toamasina, in late August. One of the passengers of this vehicle was a leper from Ankazobe who died in Moramanga, August 28.

Yesterday, twenty patients are still under treatment in hospital in Toamasina. Two hundred and sixteen are healed, from the first cases, the report of the Ministry of Public Health, on 21 October. In Toamasina, the epidemic began to stabilize until rumors of vaccines against plague have panicked the population, last week. Residents refused to take advantage of all interventions at the community level, chasing health workers with improvised weapons.

In the Ministry of Public Health, the fear of a resurgence in the number of sick reborn. "By refusing chemoprophylaxis, people can get sick and pass the disease to others," says a source with regret. Dr. Raymond Rakotoarimanana reassures that response interventions at community level are already included, following the cooperation with local authorities.

The hundred dead bar exceeded

The bar has been exceeded a hundred dead. The Ministry of Public Health reported Saturday that one hundred and seven people have died since the beginning of the plague season in August. It is likely that there are still cases of death not listed. In the report sent by the National Bureau of Risk Management and Disaster (BNGRC) on Saturday, it was clarified that there is sixty-one unknown statutes, living or dead, and twenty-two cases currently under investigation at the community level. In Antananarivo, another child died of the disease in a children's hospital in this weekend. Twenty-nine patients were admitted to hospital on 21 October. And the thousands of cases recorded since August, six hundred and four to twenty are cured. Two hundred and twenty still undergoing treatment.

Miangaly Ralitera


http://www.lexpressmada.com/blog/actualites/epidemie-un-francais-succombe-a-la-peste-a-toamasina/
 
Translation Google

Epidemic - Thirty interns infected by the plague

24.10.2017 | 7:00 News, alaune, Social1

Interns denounce the low protective equipment in the treatment of plague victims. They threaten to interrupt their activities.

Presentations. Thirty interns have contracted the bacteria of plague by intervening in the management of patients, since the beginning of the epidemic.

The announcement was made by Hery Perez De Cuellar, president of the National Association of Interns inside the University Hospital Joseph Ravoahangy Andrianavalona (CHU JRA) yesterday. "We are weakly protected in the care of patients. The mouth cover used are those used by surgeons. The on-blouses are changed only every 24 hours. And at the beginning of the epidemic, we bought ourselves this equipment, "said the student of the medical school, shocked.

These interns, students of 7th and 8th years of the Faculty of Medicine, are an integral part of health personnel involved in the care of plague victims. "We receive the patients at the triage, do the tubing or the puncture for the rapid diagnostic test, make the injection of the patients. Sometimes we take the sample on a corpse. So any time we are exposed to the bacteria", testified these future doctors.

If the majority of these interns with plague are already healed, some still undergoing treatment at the moment. Others are on chemoprophylaxis for contact.

Suspension of activity

These interns threaten to suspend their activities from today, if they do not have personal protective equipment. "We are not going to expose our lives to such a danger, however, knowing that other health workers receive more appropriate protection," they say.

The Ministry of Public Health denies that information.

"They exaggerate. The routing of equipment has taken a slight delay, but that's it, they arrived and were given to beneficiaries this afternoon (note: yesterday), "replies a source in the Ministry of Public Health.

These interns are not the only stakeholders victims of this disease since the beginning of the epidemic. In two months, at least two dozen doctors, paramedics and other health workers, have been affected and were cured.

One hundred and twenty four deaths

The cumulative number of deaths from August 1 to October 23 was 124 on 1192, according to the latest figures obtained from the Ministry of Health yesterday. Suspicious death was recorded in the region of Atsimo-Andrefana, another in Toamasina and the last in the region Itasy. The case fatality rate increases to 10.4% against 10.2%, about ten days ago. Eighteen new cases were reported in hospitals yesterday, and in the same day, thirty-six patients were able to return home them healed.

Miangaly Ralitera

http://www.lexpressmada.com/blog/ac... trentaine dinternes contamines par la peste/
 
Plague kills 124 in Madagascar, cities most affected - report

[FONT=freight-book, serif]Oct 25 , 2017[/FONT]

KIGALI (Reuters) - A plague epidemic in Madagascar has killed 124 people since August in an outbreak that has hit the island?s two main cities the hardest, the authorities said on Wednesday.

Plague is endemic in Madagascar, but the outbreak that has caused 1,192 suspected cases since August is especially worrying because it started earlier in the season than usual and has hit urban rather than rural areas.

In addition, two thirds of the cases are of the pneumonic plague, the deadliest form of the disease.
?The total number of cases (1,192) is already three times higher than the average annual total,? the National Office for Risk and Disaster Management said in a report on Wednesday.

Last week a World Health Organization report said the death toll stood at 94.

The capital Antananarivo and Toamasina, the two largest cities in Madagascar, an island in the Indian Ocean, were the most affected, with 55 percent of cases recorded there.

To date 54 medical staff have been infected, it said.
 
...
Plague Madagascar


1 554 Cases
113 Deaths
CFR 7%


EVENT DESCRIPTION
The outbreak of plague in Madagascar continues to improve, with the number of
new cases of pulmonary plague declining in all active areas across the country. In
the past 2 weeks, 16 previously affected districts reported no new confirmed or
probable cases of pulmonary plague.

From 1 August to 27 October 2017, a total of 1 554 suspected cases of plague,
including 113 deaths (case fatality rate 7%), were reported. Of these, 985 (63%)
were clinically classified as pulmonary plague, 230 (15%) were bubonic plague,
1 was septicaemic, and 338 were unspecified (further classification of cases is
in process). Since the beginning of the outbreak, 71 healthcare workers (with no
deaths) have been affected.

Of the 985 clinical cases of pneumonic plague, 245 (25%) were confirmed, 336
(34%) were probable and 404 (41%) remain suspected (additional laboratory
results are in process). Fourteen strains of Yersinia pestis have been isolated and
were sensitive to antibiotics recommended by the National Program for the Control
of Plague.

Between 1 August and 27 October 2017, 28 districts reported confirmed and
probable cases of pulmonary plague. During the last two weeks, the number of
districts that reported confirmed and probable cases of pulmonary plague reduced
to 12.

About 78% (4 825) of 6 203 contacts identified completed their 7-day follow up and
a course of prophylactic antibiotics. A total of nine contacts developed symptoms
and became suspected cases. On 27 October 2017, 1 055 out of 1 087 (97%)
contacts were followed up and provided with prophylactic antibiotics.
...
Read the weekly bulletin on outbreaks and other emergencies - Week 43: 21 - 27 October 2017


http://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates
 
Translation Google

Plague epidemic: 128 deaths and 1000 patients cured from August to October

Copywriting Midi Madagasikara November 2, 2017

Seven new cases of plague on the day of October 31, 2017.

The trend is now downward as judged by the number of people admitted to plague treatment centers in recent days. According to data from the Ministry of Public Health and published by the National Office of Risk and Disaster Management (BNGRC) on October 31, 2017, 83 plague patients are still under treatment today, October 31, in hospitals and plague treatment centers throughout the national territory. The Analamanga region has the largest number with 36 patients including 13 at CHAPA (Ambohimiandra anti-plague hospital), followed by the Haute Matsiatra region with 16 patients still under treatment.

Since the beginning of August, the plague epidemic has killed 128 people, 62 of whom have died outside the hospital. No deaths, however, have been reported this day of 31 October. Currently, the mechanisms already in place to reduce the risk of spreading the epidemic are still maintained or even reinforced in some localities where new cases have been recorded during the week. This is the case for the Analamanga, Vakinankaratra, Atsinanana and Haute Matsiatra regions.

In schools, the series of measures applied in private schools that have already returned to school remain in place. These include the establishment of an isolation room in the event of a suspected case, and a vigilance committee to implement other measures recommended by the Ministry of Health, including temperature measurement and hand washing with disinfectant gel at the entrance of the establishments for all students, teachers and any other person entering the institution. These measures will be maintained until the declaration of the end of the epidemic.

Hanitra R.

http://www.midi-madagasikara.mg/soc...deces-et-1000-malades-gueris-daout-a-octobre/


--------------------------------------------------------------------------------------------------------------------------

Antananarivo - Three deaths suspected of plague in the community

02.11.2017 | 8:34 AM News, Social0

The calm of the plague has been broken by the suspicious death of three people in Antananarivo, Tuesday and Wednesday. Unlike the cases reported recently, they all died at the community level with a rapid diagnostic test (RDT) positive for plague, as reported by the Municipal Bureau of Health (BMH) of the Urban Commune of Antananarivo (AUC), which supports the deceased outside health facilities and burial of plague victims in the city of Antananarivo. These deaths were recorded in Andohamandry Manjakamiadana at Andrainarivo and Ampahibe. The first two happened Tuesday and the last, Wednesday. The Ministry of Health has not yet confirmed the cases in Andrainarivo and Amparibe.

The one in Andrainarivo would be homeless. "He bowed out on the street," reports a source at the BMH. It would be, thus, the first homeless victim of the plague in the capital. "If the response is not reinforced, the disease will spread quickly to his family and all those who came into contact with him," says a doctor. The BMH took his body for burial in the grave of Anjanahary last night.

Blocking

An hour before that, the remains of the deceased in Andohamandry Manjakamiadana remains were buried in Anjanahary. The burial of the remains blocked agents BMH in its activities. Relatives of the victim have accepted neither the finding of the doctors nor the result of the TDR, and have refused to give the body. "We understand that it's hard. But would not it be better to accept to prevent the disease makes other victims? "says a doctor.

The deaths at community level should be alarming indicators for the Department of Public Health. People probably think that the danger is past, with the decline of the victims. So, they will not join the health facilities, despite the presence of symptoms, namely high fever, chills, fatigue, chest pain, cough with sputum streaked with blood. The active case, awareness and all response activities should be strengthened.

Lost in nature

Yesterday, the Secretary General of Public Health, Dr. Jos?a Ratsirarson emphasized that the plague victim who escaped the anti-plague hospital in Ambohimiandra (CHAPA), last Thursday, has not been found. "We do not know what has become of him. The last time we joined him on the phone, he agreed to come back to the hospital for treatment, so far he has not pointed his nose, "he says. We do not know until yesterday, it is one of those died in Antananarivo. On 31 October, eighty-three people were under treatment at the facility level, a thousand people have been cured since the beginning of the epidemic and seven new cases were recorded throughout Madagascar. With these three cases, the number of deaths would amount to a hundred and twenty nine.

Miangaly Ralitera

http://www.lexpressmada.com/blog/ac...s-morts-suspects-de-peste-dans-la-communaute/
 
Translation Google

Eliane Naika: "The figure of 128 deaths related to the plague is below reality"

LINFO.RE - created the 2.11.2017 at 13h13 - updated on 2.11.2017 at 16h29- Manuel Yepes
...
To talk about the plague in Madagascar, former Malagasy senator Eliane Naika is on the set of Antenne R?union.

According to the latest assessment on October 24, 1,133 people were infected with the plague, and 128 died. But for Eliane Naika, these figures do not reflect reality.

"There has not been an in-depth census of the reality, there are a lot of people in the bush who have died and I think have not been counted in. I do not recognize that figure of 128 deaths. I can put a number on the number of affected areas, of the 22 regions, 17 regions are affected, that's a huge number, which is a figure that came out of the cases that came out everywhere. This number is real. On the other hand, I can not give an exact number of deaths. "

...

http://www.linfo.re/la-reunion/societe/729789-eliane-naika
 
"The deadly airborne plague spreading rapidly across Madagascar is now at 'crisis' point as cases have rocketed by 37 per cent in just five days, official figures reveal.

The outbreak, the 'worst in 50 years', is being fueled by a strain more lethal than the one which usually strikes the country off the coast of Africa.

The World Health Organization (WHO) now states there are 1,801 suspected cases - significantly higher than the 1,309 it reported last Thursday."

(continues)

http://www.dailymail.co.uk/health/ar...rocket-40.html
 
Plague – Madagascar

Disease outbreak news

2 November 2017


Since August 2017, Madagascar is experiencing a large outbreak of plague affecting major cities and other non-endemic areas.

From 1 August through 30 October 2017, a total of 1801 confirmed, probable and suspected cases of plague, including 127 deaths, have been reported by the Ministry of Health of Madagascar to WHO. Of these, 1111 (62%) were clinically classified as pneumonic plague, including 257 (23%) confirmed, 374 (34%) probable and 480 (43%) suspected cases. In addition to the pneumonic cases, 261 (15%) cases of bubonic plague, one case of septicaemic plague and 428 cases (24%) where the type has not yet been specified, have been reported (Figure 1). As of 30 October, 51 of 114 districts of Madagascar have been affected (Figure 2 and 3). Since the beginning of the outbreak, 71 healthcare workers have had illness compatible with plague, none of whom have died.

Laboratory confirmation of plague is being conducted by the Institut Pasteur of Madagascar. Twenty-three isolates of Yersinia pestis have been cultured and all are sensitive to antibiotics recommended by the National Program for the Control of Plague.

Since the second week of October 2017, there has been a decline in the number of new cases (Figure 4). There is also a decrease in the number of patients hospitalized due to suspicion of plague. Due to enhanced surveillance and ongoing investigations the cumulative number of cases continues to increase, however, some of the cases are not recently infected.

In Madagascar, the number of cases of plague is highest during the period of September through April. It is therefore important that control measures continue
through to the end of April 2018.


Eighty-three percent of 6492 individuals identified as contacts of a person suspected of having plague have completed follow-up monitoring, which includes a seven day follow-up and a course of prophylactic antibiotics. On 30 October 2017, 95% of the 972 contacts currently under follow-up were reached by field teams and have been provided with antibiotics as precautionary measure.

Figure 1. Confirmed, probable and suspected plague cases reported in Madagascar by clinical classification and date of illness onset, from 1 August through 30 October 2017 (n=1506)1

figure1.png



1 Date of onset is missing for 295 cases.
Figure 2. Geographical distribution of confirmed, probable and suspected bubonic plague cases reported in Madagascar, from 1 August through 30 October 2017

figure2.PNG



Figure 3. Geographical distribution of confirmed, probable and suspected pneumonic plague cases reported in Madagascar, from 1 August through 30 October 2017

figure3.PNG



Figure 4. Epidemic curve of reported confirmed, probable and suspect pneumonic plague by date of illness onset in Madagascar, from 1 August through 30 October 2017 (n=1053)2

figure4.png



2 Date of onset is missing for 58 cases.

Public health response

The Ministry of Public Health of Madagascar is coordinating the health response, with the support of WHO, and other agencies and partners.

The Ministry of Public Health of Madagascar has activated crisis units in Antananarivo and Toamasina and all cases and contacts have been provided access to treatment or prophylactic antibiotics at no cost.

Public health response measures include:
  • Investigation of new cases
  • Isolation and treatment of all pneumonic cases
  • Enhanced case finding
  • Active finding, tracing and monitoring of contacts and provision of free prophylactic antibiotics
  • Strengthened epidemiological surveillance in the all affected districts
  • Disinsection, including rodent and vector control
  • Raising public awareness on prevention for bubonic and pneumonic plague
  • Raising awareness among health care workers and providing information to improve case detection, infection control measures and protection from infection
  • Providing information about infection control measures during burial practices.
Enhanced measures for exit screening have been implemented at the International Airport in Antananarivo. These measures include: filling a special departure form at the airport (to identify passengers at risk); temperature screening of departing passengers, and referring passengers with fever to airport physicians for further consultation; passengers with symptoms compatible with pneumonic plague are immediately isolated at the airport and investigated using a rapid diagnostic test and notified according to the response alert protocol. Symptomatic passengers are not allowed to travel. A WHO GOARN team (US Centers for Disease Control and Prevention (CDC) and L'Institut de veille sanitaire/ Sant? publique France (InVS/SPF) is providing technical support at the airport.

Nine countries and overseas territories in the African region (Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La R?union (France), Seychelles, South Africa, and Tanzania) have been identified as priority countries for plague preparedness and readiness by virtue of their trade and travel links to Madagascar.

These countries are implementing readiness activities including increased public awareness of plague, enhancing surveillance for the disease particularly at points of entry and prepositioning of equipment and supplies.


WHO risk assessment

While the declining trend in new plague case reports and reduction in hospitalizations due to plague is encouraging, WHO expects more cases of plague to be reported from Madagascar until the typical plague season ends in April 2018. Sustaining ongoing operations, including active case finding and treatment, comprehensive contact identification, follow-up and antibiotic treatment, rodent and flea control, and safe and dignified burials is crucial during the outbreak and through the plague season as it is critical to minimize bubonic plague infections and human-to-human transmission of pneumonic plague.

Based on available information and response measures implemented to date, WHO estimates the risk of potential further spread of the plague outbreak at national level remains high. The risk of international spread is mitigated by the short incubation period of pneumonic plague, implementation of exit screening measures and advice to traveller to Madagascar, and scaling up of preparedness and operational readiness activities in neighbouring Indian Ocean islands and other southern and east African countries. The overall global risk is considered to be low. WHO is re-evaluating the risk assessment based on the evolution of the outbreak and information from response activities.

Advice on prevention and control measures, treatment options have been provided to Madagascar and to priority countries in the region.

For further information on plague and the latest information about the plague outbreak in Madagascar please see WHO Plague website and the Madagascar Plague Outbreak Situation Reports website.
WHO advice on travel

Based on the available information to date, the risk of international spread of plague appears very low. WHO advises against any restriction on travel or trade on Madagascar based on the information available.

International travellers arriving in Madagascar should be informed about the current plague outbreak and the necessary protection measures. Travellers should protect themselves against flea bites, avoid contact with dead animals, infected tissues or materials, and avoid close contact with patients with pneumonic plague. In case of sudden symptoms of fever, chills, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tainted sputum, travellers should immediately contact a medical service. Travellers should avoid self-medication, even if for prophylaxis. Prophylactic treatment is only recommended for persons who have been in close contact with cases, or with other high risk exposures (such as bites from fleas or direct contact with body fluids or tissues of infected animals). Upon return from travel to Madagascar, travellers should be on alert for the above symptoms. If symptoms appear, travellers should seek medical care and inform their physician about their travel history to Madagascar.

http://www.who.int/csr/don/02-novemb...madagascar/en/
 
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