Madagascar: plague outbreak 2018-19

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Madagascar: two dead because of the plague

By Le Figaro.fr with AFP Updated on 18/09/2018 at 13:56 Published on 18/09/2018 at 13:25

The plague had its first victims of the year in Madagascar, where the health authorities announced that they had recorded since August two cases of fatal contamination by the bacillus, which had killed more than 200 people last year. "According to censuses conducted between August 1 and September 13, there were eight suspected cases of plague, including six cures and two deaths in villages," said Manitra Rakotoarivony AFP from the Ministry of Public Health. The first fatal case was identified in Fiadanana, north of the capital Antananarivo, the second in the district of Ambalavao (center), said Dr. Rakotoarivony.
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http://www.lefigaro.fr/flash-actu/2...-premiers-morts-de-la-saison-a-madagascar.php

 

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Madagascar: measures to prevent the epidemic of plague

By RFI Published on 19-09-2018 Last modified on 19-09-2018 at 11:45

In Madagascar, the Malagasy authorities make an initial assessment at the beginning of the plague season. The disease returns every year in the country from August to April. Last year, she had killed more than 200 people. Since early August, it has already killed two people and reached eight people in endemic regions of the plague. But the Malagasy authorities say they have put in place "a plan of attack" to prevent a new epidemic of great magnitude.

Awareness campaigns on television and national radio, antibiotics already available at the district level, disinfection and disinsection: it is with these measures that the Malagasy authorities hope to avoid a new outbreak of plague.

Dr. Manitra Rakotoarivony, Director of Health Promotion for this department, also requests the cooperation of the transit companies: "Every carrier must enter the names of the passengers, their telephone contact in case there is an infected person in the bus. This is our problem because there are several [companies] who do not use this notebook ".

A major problem since this is how the plague spread last year. A passenger with the disease had contaminated other passengers. The urgency is now to find all the people in contact to be able to do a preventive treatment.

Of the eight plague cases recorded this year, four are cases of pneumonic plague. Information that worries Dr. Manitra Rakotoarivony: "Without treatment, bubonic pests turn into lung plague and that's why the ministry team is worried. Because there are people who have not gone to take the treatment, it is very problematic because traditional healers do not use drugs, they use other methods that are not effective. "

Encourage people to seek treatment from a doctor is the challenge of the authorities. The first form of plague, bubonic transmitted by the fleas of rats, is the least dangerous. Pneumonic plague is transmitted from person to person by saliva droplets. Very contagious, it can be deadly in only 48 hours.

http://www.rfi.fr/afrique/20180919-madagascar-epidemie-peste-mesures-prevention

 

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The plague begins to rage

Wednesday, September 19th | Arena R.

The plague is back, four (4) deaths and eleven (11) suspected cases have been reported. The first fatal case was recorded at Fiadanana Ankazobe, Analamanga region, last August, the second at Ambalavao Fianarantsoa, ​​Amoron'i Mania region, on September 8th. Yesterday again, a peasant couple succumbed to the plague on the side of Analavory...
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Regarding suspected cases, Dr Manitra Rakotoarivony, health development officer at the Ministry of Health, reports that six of them, including three cases of pulmonary plague, are already cured after receiving the necessary treatment. This is also the case for the 113 people who attended the victim in the Ankazobe district. "A vast operation followed by massive care was conducted on site by the services of the Ministry of Health," he reports.

An emergency meeting, led by Prime Minister Christian Ntsay, was held Tuesday in Mahazoarivo where the government council of the week was also held. This meeting would have focused on the strategy to put in place to cope with the spread of the plague. No information was available regarding this meeting, either in the communiqu? of the Government Council or in the usual communication made by the Primature.
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https://www.madagascar-tribune.com/La-peste-commence-a-sevir,24249.html

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19-09-2018 by The Madagascar Express

The number on the plague increases slowly. The disease hit a peasant family at Analavory yesterday.

Drama in a small village in Analavory. Four young children lost their parents simultaneously yesterday morning. Plague caused the husband and his wife, aged 43 and 42, respectively, according to the result of their removal from a rapid diagnostic test (RDT). Their youngest child is 1.5 years old. "They were sick since Saturday, according to the report of their relatives. Unfortunately, they did not go for treatment at the health center, "says Senior First Class Constable Ga?tan Satahasimbola, Head of Advanced Station at Analavory yesterday.

It was their children who informed their loved ones of the death of their parents at around 9am. These spouses were buried, yesterday, in a false commune, to prevent the spread of the disease. The manipulation of the body of a plague sufferer presents a high risk of transmission of the disease. The Ministry of Public Health and the World Health Organization have already presented the dignified and secure burial model to make possible the burial of a plague victim in the family tomb, but it is not yet effective.

Spread of fires

The children of these new victims of the plague would not have presented the symptoms of the plague until yesterday, but it is very likely that they were contaminated. Pulmonary plague is transmitted by respiratory droplets, while they have been in contact with their parents all the time. Seventy people in contact with the deceased, including these children, received the plague prevention drugs. The village has been disinfected.

This would be the first time that the plague is killing victims in this village, 30 kilometers from Analavory. "It is surely the spread of bush fires that caused this disease. Everything went on fire around the village and the rats go up to the village, "says the source. These rodents transmit the plague to humans, through fleas.

The elimination of the plague is for the moment impossible. Cases should always be expected to occur each plague season. Because as long as we practice bush fires, as long as we live in unhealthy conditions, and as long as we continue to bury people who have succumbed to the plague in the family tomb and reopen it before the age of seven, we remain exposed to the disease. The important thing is to seek treatment at a health facility in case of high fever, fatigue, physical discomfort, headache, bubo, coughing with blood. On the prevention side, this is a multisectoral fight, everyone has their share of responsibility.

Eleven suspected cases

These two deaths bring to eleven the number of plague cases recorded so far. Four deaths and seven recoveries in five regions, namely Analamanga, Amoron'i Mania, Upper Matsiatra, Itasy and Menabe. The cross-checking of information at the level of doctors proves difficult. A memo would suspend them from giving information about the plague without the approval of their minister. At the level of the Ministry of Public Health, the information is published only every Monday. But the population needs to know the information in time to take the appropriate measures.

Miangaly Ralitera

http://www.moov.mg/actualites/natio...des-époux-succombent-simultanément-à-la-peste

 

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There is no plague epidemic, says health minister

Friday, September 21st | Arena R.

"There is no epidemic of plague in Madagascar, there is nothing to fear for now." The comments were made by the Minister of Public Health, Harinirina Rantomalala, at a press conference at his office in Ambohidahy. This media outlet of the first person in charge of this ministerial department and its staff had for objective to reassure the population on the return of the plague on the national territory these last times.

Since the month of August, 13 suspected cases of plague, including 2 deaths, have been reported in 7 districts out of 114, according to the report of the Ministry of Health. Both deaths were recorded in Ankazobe on 19 August and in Ambalavao on 7 September. These are indeed cases of plague, pulmonary and bubonic. Of the remaining 11 cases, three have been confirmed and patients are already undergoing the necessary treatment. "This is nothing compared to the 54 cases confirmed last year, at the same time," says the minister.

Professor Harinirina Rantomalala also highlighted the "i's" regarding the suspicious death of a couple at Analavory this week. "The tests are in progress and the results will have to be known from here," he said.

The Minister of Health says he has taken all necessary measures to limit the spread of plague in the country. This is particularly the case of the registration of passengers' names in bus stations in order to facilitate the follow-up of their care in case of suspicion of plague.

https://www.madagascar-tribune.com/Il-n-y-a-pas-d-epidemie-de-peste,24256.html

 

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COMMUNICATION ON THE SITUATION OF PEST IN MADAGASCAR on 21 September 2018

Written on Monday 24 September 2018 by M Vola Sdri
From Monday, September 24, 2018 to Monday, September 24, 2018

Madagascar is currently in the middle of the plague transmission season.

From August 1 to September 20, 2018, sixteen (16) suspected cases of plague were reported centrally, of which five (05) were biologically confirmed.
Districts reporting suspected plague cases were 08, including Ambalavao, Ambatofinandrahana, Ambositra, Ankazobe, Fandriana, Miarinarivo, Morondava and Antsirabe I.

Of the 5 confirmed cases, two (2) were classified bubonic plague and three (3) were pneumonic plague.

The first case of bubonic plague was reported on 19 August 2018 and concerned a resident of Ankazobe District (Fiadanana Commune), with a favorable course of the disease.

The second case of bubonic plague, reported on August 25, 2018, was in Ankazobe District (Fiadanana Commune) and died on August 28, 2018.

The patient with pneumonic plague who was notified on 04 September 2018, resided in the district of Ambalavao (Commune Iarintsena) and died on 07 September 2018.

In the case of the couple in their forties who died on 18 September 2018, living in Alatsinainikely commune, Miarinarivo district, the investigations confirmed that the cause of their death was pneumonic plague.
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http://www.sante.gov.mg/home/n

 

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Source: http://infosurhoy.com/cocoon/saii/x...adagascar-says-plague-outbreak-under-control/

Madagascar says plague outbreak ?under control?
By Marta Subat on September 28, 2018 News Summary

Madagascar?s seasonal outbreak of plague, which has so far killed two people, is ?under control?, Health Minister Yoel Rantomalala said Thursday.

?We have recorded from August 1 to September 17, 13 suspected cases of plague, three of which are confirmed and caused two deaths,? Rantomalala said.

The first fatality was recorded in Fiadanana, north of the capital Antananarivo, while the second was reported in Ambalavao in the Indian Ocean island?s interior.

?For the moment, the situation is under control, we are on the right track,? he told reporters...

 

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Outbreaks and Emergencies Bulletin, Week 39: 22 - 28 September 2018
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Plague Madagascar
25
Cases
6
Deaths
24%
CFR

EVENT DESCRIPTION
On 19 August 2018 (week 34), a suspected case of bubonic plague was
reported from Ankazobe district, a plague endemic area in the central
highlands, where the last epidemic started in August 2017. This initial
case was a 41-year-old male living in the rural community of Fiadanana.
He was confirmed by polymerase chain reaction (PCR) and culture at
Institut Pasteur de Madagascar (IPM) and is currently being treated.
Subsequently, additional suspected bubonic and pneumonic cases were
reported from five endemic regions in central highlands.
As of 27 September 2018 (week 39), a total of 25 cumulative cases
including five community deaths (case fatality ratio 20%) have been
reported from nine districts across five endemic regions, namely, HauteMatsiatra,
Amoron?I Mania, Itasy, Vakinankaratra, and Analamanga. Six
of these 25 suspected cases have been laboratory confirmed by RDT,
PCR and/or culture at IPM (three pneumonic and three bubonic cases)
and 19 are currently classified as suspected cases. Four of the five deaths
were reported among confirmed cases; three in confirmed pneumonic
cases and one in confirmed bubonic cases. The six confirmed cases
have been reported across four regions: Analamanga (2 cases), Haute
Matsiatra (1 case), Itasy (2 cases) and Amoron?I Mania (1 case) regions.
Among the remaining 19 suspected cases, 10 (53%) presented clinical
signs compatible with pneumonic plague, while 9 (47%) had a clinical
presentation of bubonic plague.
The first confirmed pneumonic case was a 36-year-old female from
Ambalavao district, Haute Matsiatra region in the central highlands.
She developed respiratory symptoms on 5 September 2018 and died
on 7 September 2018 in the community. The last two confirmed cases
of pneumonic plague were a couple from Miarinarivo district, in Itasy
region. The husband, aged 38 years, developed severe respiratory
symptoms on 15 September 2018 and died on 18 September 2018. Prior
to his death, he participated in a religious gathering on 14 September
2018 in Analavory town, Miarinarivo district. His 24-year-old wife, died
one hour after his death, following symptom onset on 16 September
2018. All confirmed pneumonic cases were confirmed post-mortem
and are currently classified as primary pneumonic plague cases; their
contacts are currently under follow-up.
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SITUATION INTERPRETATION
Plague is endemic on the Plateaux of Madagascar. Cases are typically recorded from September to April. Although bubonic cases are predominantly reported during the endemic season, pneumonic cases are also expected and are associated with human-to-human transmission and a high case fatality of 30-100% if left untreated. The recently notified cases of confirmed pneumonic cases have been reported from endemic and non-overcrowded areas so far. However, deaths among these cases have occurred in the community. There is currently no information concerning the source of infection of the three confirmed pneumonic cases. But, given their classification as primary pneumonic plague cases, it is important to investigate potential unidentified transmission chains in order to mitigate the risk of spread of the disease to other districts and major urban centres. Madagascar is experienced in the management of plague outbreaks. Further spread of the disease to highly populated cities could be prevented by strengthening preparedness and readiness activities in districts neighbouring the affected areas and at entry points, scaling up infection prevention including safe burials and vector control, enhancing community engagement, strengthening epidemiologic surveillance and ensuring early linkage to care in the affected areas. National and international authorities need to act swiftly to put these measures in place.

http://apps.who.int/iris/bitstream/h...2228092018.pdf

https://afro.who.int/publications/ou...september-2018

 

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Epidemiological Bulletin of Plague: 10 deaths and 38 cases in 3 months

Copywriting Midi Madagasikara November 9, 2018

In three months, from 1 August to 5 November, the plague epidemiological bulletin, provided by the Ministry of Public Health, reported 10 deaths and 38 cases of plague (all forms combined).

Note that we are talking here about confirmed cases following the investigations made by the MSP agents on the ground; and not cases that are supposed and still not identified. This figure is therefore subject to variations. For the moment, the bubonic form has the greatest number of cases. 32 cases of plague of the 38 identified are in fact bubonic form if the other six are of pulmonary form. These six cases of pulmonary plague have all ended in death; while for the bubonic form, only 4 out of 32 died there. According to information from the Ministry of Public Health, the remaining 28 people are still being treated at the health center level.
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http://www.midi-madagasikara.mg/soc...que-de-la-peste-10-deces-et-38-cas-en-3-mois/

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http://www.sante.gov.mg/home/n

 

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Pulmonary plague: No survivor among the 9 confirmed cases

Redaction Midi Madagasikara November 16, 2018
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43 cases of plague, all forms combined, were recorded in 15 weeks, including 9 cases of pneumonic plague, all of which died, plus 34 cases of bubonic plague, including five deaths and 24 survivors.

Five more cases than last week. The latest figures reported by the Ministry of Public Health in the epidemiological bulletin of the plague show five new confirmed cases of plague compared to the 38 cases reported for the period from 1 August to 5 November 2018. These five new confirmed cases bring back thus to 43 the number of confirmed cases from August 1 to November 12, 2018. Of these 43 plague patients, 34 developed bubonic plague of which 29 were treated by health facilities and are in the process of being cured, some have already healed, if the other five have succumbed. This indicates a 1.7% death rate among bubonic plague patients.

Fatal issue. As for pulmonary plague, the mortality is 100%. In fact, of the 43 cases of confirmed plague, nine are cases of pulmonary plague. None of them survived. These confirmed cases of pneumonic plague were located in Tsiroanomandidy districts where four cases were confirmed; Manandriana (a case); Southern Midongy (one case); Ambalavao (one case) and Miarinarivo (two cases). The situation confirms the devastating character of the pulmonary plague which kills in only a few hours. The delay in the management or even the absence of treatment when the patients do not join the health facilities as soon as the symptoms appear, favors this extremely rapid evolution of the disease towards the death. A dramatic outcome for families and loved ones. Recall that 13 districts are affected by the plague, namely Faratsiho, Betafo, Ambositra, Moramanga, Miarinarivo, Ankazobe, Anjozorobe, Ambalavao, South Midongy, Ambatofinandrahana, Befotaka, Manandriana and Tsiroanomandidy.
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http://www.midi-madagasikara.mg/soc...re-aucun-survivant-parmi-les-9-cas-confirmes/

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Plague: The cap of 50 cases exceeded, 17 deaths

Writing Midday Madagasikara December 6, 2018 0 Comment

According to the latest bulletin on the epidemiological situation issued by the Ministry of Public Health, 52 cases of plague were confirmed from 1 August to 3 December 2018.

In 18 weeks, 52 plague cases in all forms were confirmed. Among them, 41 cases of bubonic plague whose outcome was fatal for seven victims, if the remaining 34 survived after being taken care of by the health structures. Recall that 13 districts are, so far, affected by the plague, namely Tsiroanomandidy, Befotaka, Manandriana, Ambalavao, Ambatofinandrahana, Miarinarivo, South Midongy, Anjozorobe, Ankazobe, Moramanga, Ambositra, Betafo and Faratsiho. The assessment is much heavier for the cases of pulmonary plague: out of the 11 confirmed cases - of which five located in Tsiroanomandidy- ten resulted in the death of the victims. Thus, a total of 17 plague deaths were recorded.

Speed. It must be known that pulmonary plague can kill in a few hours in the absence of immediate management. A patient who develops the first symptoms in the night may not survive until morning. However, pulmonary plague does not necessarily lead to death, if the affected subject is immediately taken care of. As evidence, the only survivor among the 11 cases of pulmonary plague. Generally speaking, with regard to both forms of the plague, it is the delay in the decision to reach the hospitals or the health centers, or the removal, which is at the origin of the delay in the assumption of responsibility patients with the disease. Delay difficult to catch up and which often evolves towards the death.

Still spared. To date, no case has been reported or confirmed in Antananarivo. Nevertheless, the fear of the plague in the capital began to reach the Tananarivians, because of the problem of garbage removal that persisted for several months. In recent days, an improvement has been observed in some neighborhoods but the effort would be better intensified. Some sites such as large markets, however, are experiencing some delays in garbage collection. As a result, garbage continues to pile up while the trucks and garbage men come to the rescue. The reinforcement of the regulations on the schedules of exit of the bins towards the public bins (from 17h to 20h) made it possible to avoid the accumulation of the waste during the day. The effects of sun and rain on the mountains of garbage are at the origin of the proliferation of microbes of all kinds, and facilitate the development of diseases, including the plague so much feared by the population. In the event of a suspicious situation, the Ministry of Health encourages the public to approach health facilities immediately or to call toll free 910.

Hanitra R.

http://www.midi-madagasikara.mg/societe/2018/12/06/peste-le-cap-des-50-cas-depasse-17-deces/

 

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Plague: 60 confirmed cases including 18 deaths

Copywriting Midi Madagasikara December 13, 2018 0 Comment

From 1 August to 7 December 2018, 141 plague cases were reported, of which 60 are confirmed and 75 remain suspect cases. All these cases were notified in 24 health districts. According to the laboratory analyzes carried out at the Central Pest Laboratory (LCP), of the 60 confirmed cases, 18 died, of which 10 were pulmonary and eight were bubonic. In other words, 42 are alive, 41 of bubonic form, and one of pulmonary form. It should also be noted that six cases, all of bubonic form, are currently waiting for sampling.
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http://www.midi-madagasikara.mg/societe/2018/12/13/peste-60-cas-confirmes-dont-18-deces/