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Year : 2018  |  Volume : 3  |  Issue : 3  |  Page : 74-75

Containing the 2017 plague outbreak in Madagascar: World Health Organization

1 Department of Community Medicine, Member of the Medical Education Unit & Medical Research Unit, Chennai, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication18-Oct-2018

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ed.ed_14_18

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How to cite this article:
Shrivastava SR, Shrivastava PS. Containing the 2017 plague outbreak in Madagascar: World Health Organization. Environ Dis 2018;3:74-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Containing the 2017 plague outbreak in Madagascar: World Health Organization. Environ Dis [serial online] 2018 [cited 2023 Jun 5];3:74-5. Available from: http://www.environmentmed.org/text.asp?2018/3/3/74/243630

Dear Editor,

Plague is an infectious zoonotic disease of bacterial origin, with the agent being present in small mammals and their fleas.[1] The disease occurs in two forms, namely bubonic and pneumonic with a case fatality ratio of 45% and 100% (if untreated), respectively.[1] The available global estimates suggest that close to 3250 cases and case fatality ratio of 18% have been reported between 2010 and 2015.[1]

A new outbreak of the disease has been reported in Madagascar since the month of August and till the end of October, in excess of 1800 suspected, probable and confirmed cases and more than 125 deaths have been reported.[2],[3] The current outbreak is anticipated to be severe due to its early onset, rapid spread to new areas (other than the common ones), and there are 5 more months remaining before the disease season comes to an end.[2],[3],[4] Considering the fact that the disease is still associated with panic, preventable with the help of standard preventive measures, and treatable with antibiotics, it is of utmost importance to contain the outbreak and minimize the possibility of the regional transmission of the disease.[2],[3]

Anticipating the risk, the World Health Organization (WHO) has performed an immediate assessment of the chances of disease transmission based on the nation's capacities and susceptibility.[3] It was observed that there was a high, moderate, and low risk for the disease to spread at the national, regional, and global level, respectively.[3] Standard measures, such as identification and end the source of infection, protection of health personnel, ensuring provision of right treatment, strengthening of surveillance activities, isolation of patients of pneumonic form, administration of chemoprophylaxis to the close contacts, promotion of early detection through the collection of right specimen, encouragement of standard disinfection measures, and promotion of safe burial practices, have been advocated.[1],[2],[3]

Further, the efforts have been taken to improve the exit screening at the airport by providing information about the disease to the travelers (viz. symptoms, mode of transmission, preventive measures, and treatment), screening of passengers, and even isolation, if required.[2],[3] In addition, the WHO has distributed almost 1.2 million doses of antibiotics to the health facilities and mobile clinics, and even supported the response activities by providing financial assistance to the nation.[5] Moreover, different international welfare agencies have also joined in containing the outbreak, and steps have also been taken to ensure standardized case management and facilitate community engagement.[3]

Finally, the assessment has been done in the neighboring nations and territories regarding their preparedness (viz. national coordination mechanisms, logistical, epidemiological, and laboratory surveillance capacities) and prevailing gaps, so that appropriate rectification can be done.[1],[3] Furthermore, the status of emergency response teams, mechanisms for risk communication and community engagement, and quality of preparedness at points of entry have also been evaluated.[3] Further, it has been envisaged to mount a coordinated response involving all the concerned stakeholders.[3]

To conclude, to prevent and contain the future outbreak of the disease, there is an immense need to have a better preparedness, plan for the optimal allocation of resources, and strengthened surveillance activities.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Plague – Fact sheet No 267; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs267/en/. [Last accessed on 2018 Aug 07].  Back to cited text no. 1
Kmietowicz Z. Pneumonic plague outbreak hits cities in Madagascar. BMJ 2017;359:j4595.  Back to cited text no. 2
World Health Organization. Madagascar Plague: Mitigating the Risk of Regional Spread; 2017. Available from: http://www.who.int/features/2017/madagascar-plague-risk/en/. [Last accessed on 2018 Aug 07].  Back to cited text no. 3
Vogler AJ, Andrianaivoarimanana V, Telfer S, Hall CM, Sahl JW, Hepp CM, et al. Temporal phylogeography of Yersinia pestis in Madagascar: Insights into the long-term maintenance of plague. PLoS Negl Trop Dis 2017;11:e0005887.  Back to cited text no. 4
World Health Organization. WHO Provides 1.2 Million Antibiotics to Fight Plague in Madagascar; 2017. Available from: http://www.who.int/mediacentre/news/releases/2017/antibiotics-plague-madagascar/en/. [Last accessed on 2018 Aug 06].  Back to cited text no. 5


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