There is a plague outbreak in Madagascar currently and its spread is unprecedented in the history of the Island. So far, it has claimed 57 lives and there has been a record of over 680 cases.

Although Madagascar experiences regular outbreaks, with about 400 cases of plague every year, the infections started earlier in the year than usual and are according not only in rural areas, but also in urban settings as well. Madagascar has 114 districts, 35 of whom have reported cases of the plague.

The surprising occurrence of cases in cities as well as the earlier presentation led to a rapid spread of the disease, as the Health authorities were not ready. The typical scenario was for the outbreaks to occur during the rainy season, between November and March, but this year, cases began three months early, in August.

There Are Different Types Of Plague:

The Bubonic Plague: The Bubonic plague, which is commonly referred to as plague, is a deadly infectious disease caused by the bacterium Yersinia pestis. This bacterium, is transmitted through the bite of infected fleas, frequently carried by rats. Symptoms include painful, swollen lymph nodes, called bubos, as well as fever, chills and coughing.

The pneumonic plague: Pneumonic plague is more virulent or damaging and is an advanced form characterized by a severe lung infection. The infection can be transmitted from person to person via airborne droplets, coughing or sneezing. The incubation period is short, and an infected person may die within 12 to 24 hours

The Septicemic plague: Occasionally there can be cases of septicemic plague, where the infection has spread to a person’s bloodstream and can cause bleeding and necrosis of tissue, turning it black.

Of the 684 cases reported as of October 12, 474 were pneumonic plague (unexpected number of cases than usual, and transmits more easily from person to person), 156 bubonic (transmitted from rat- human) and 1 septicemic plague. A further 54 were unspecified, according to the World Health Organisation (WHO).

Both Bubonic and Pneumonic forms can be treated with antibiotics, making early detection a priority.

The government has mobilized resources to fumigate schools and other public places to fight fleas and rodents and curb the spread of infection. People have also been lining up at pharmacies in the capital — some wearing face masks — to get medications or protection. To further reduce the spread of the disease, public schools are closed and the government has forbidden public gatherings, according to the International Federation of the Red Cross (IFRC).

International Control Effort

  • An international response is being mustered to support the Madagascar Ministry of Public Health, with contributions from the UK Public Health Rapid Support Team, WHO, the US Centers for Disease Control and Prevention, Medecins Sans Frontieres (Doctors without Borders), the Institute Pasteur and many others, said Bausch.
  • The UK Public Health Rapid Support Team consists of clinicians, scientists and academics that are deployed to tackle outbreaks of disease around the world within 48 hours.
  • WHO delivered more than 1.2 million doses of antibiotics and released $1.5 million in emergency funds earlier this month.
  • The Red Cross has released more than $1 million to deploy a treatment center and has mobilized more than 1,000 volunteers and is upgrading their skills on community surveillance, finding and monitoring people who have been in contact with infected patients and insightful messaging to stop the spread of this disease.


National Spread:

It is expected that there will be a further increase in spread within Madagascar because of the large population and the increased human-human transmission form of the plague. However, because surveillance has improved, health authorities will receive more reports earlier and treat appropriately, as there is now a system in place to treat people, provide drugs and trace contacts.

International Spread:

The risk of international spread is low, as people with plague are too ill to travel and will not be inclined to do so. Any international spread will likely be limited to isolated cases. The WHO is working closely with Madagascar’s airport authorities to ensure sanitary measures such as temperature checks and medical teams, are in place at airports and ports to prevent the spread of infection outside the country. The group is also working closely with neighbouring countries.

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Source: CNN, Vox, WHO