On Friday, the Centers for Disease Control and Prevention (CDC) issued a travel notice for people going to Madagascar due to the outbreak of plague on the island nation.
Although bubonic plague occurs nearly every year in Madagascar, an unusual outbreak of plague pneumonia is occurring in geographically widespread areas, including in heavily populated cities of Antananarivo (the capital city and its suburbs) and Toamasina.
Between 1 August and 8 October 2017, a total of 387 cases (suspected, probable and confirmed) including 45 deaths (case fatality rate 11.6%) have been reported from 27 out of 114 districts in the country. Seven out of 10 cases, or 277 were of the pneumonic variety- probably the most serious form of plague, which is contagious and can be transmitted person to person.
The CDC says the risk to travelers appears to be very low; however, travelers have been infected, and one died. Travelers to Madagascar should use insect repellent to prevent flea bites and avoid close contact with sick or dead animals. Travelers should also avoid close contact with ill people, especially those with cough or pneumonia.
No vaccine is available to prevent plague. Plague can be prevented with antibiotics. Travelers who have had close contact with people with plague pneumonia or other high-risk exposures should immediately notify a health care provider. They may need to take antibiotics to prevent plague. During or after travel to Madagascar, travelers should be alert for symptoms of plague, and if they appear, seek medical care and inform the provider about their travel to Madagascar.
Plague is known to be endemic on the Plateaux of Madagascar (including Ankazobe District where the current outbreak originated) and a seasonal upsurge (predominantly the bubonic form) usually occurs early every year between September and April.
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