In an update to the Madagascar plague outbreak, L’Express de Madagascar (computer translated) reports the number of cases have risen to 189, up from 138 on Nov. 25.

In addition, the number of plague fatalities now stands at 52, bringing the case fatality to 28% on the island country.
The vast majority of cases are of the bubonic plague variety (179, or 95%), 5 cases are pneumonic plague and the remaining 5 cases are unclear.
The Pasteur Institute in Madagascar have confirmed about half the cases, according to the report.
Out of the 44 districts with plague, the remaining currently infected districts in the Big Island are Amparafaravola, Miarinarivo, Tsiroanomandidy, according to health officials.
According to the general secretary of the Madagascar Ministry of Health, between 300 and 600 suspected cases are reported each year, with about 30 cases of pulmonary plague and 10 to 70 deaths.
The World Health Organization earlier this week released a statement clarifying ” that the plague is endemic in the country, with epidemic seasonal peaks ranging from September to March” after numerous media accounts on the outbreak.
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