By NewsDesk  @infectiousdiseasenews

On 29 August 2021, the Public Health, Epidemiological Surveillance and Response Department of the Ministry of Health, Madagascar received an alert from Arivonimamo health district, Itasy region, regarding a suspected community death and 15 suspected cases of pneumonic plague that occurred in the municipality of Miandrandra.

Soon the proventriculus, or esophagogastric junction will become blocked with a bacterial mass preventing the flea from swallowing food.

All the cases presented with fever, headache, weakness, shortness of breath, chest pain and cough. Plague is endemic in Madagascar and outbreaks occur regularly, although every outbreak is cause for concern. Furthermore, pneumonic plague is a notifiable disease under the International Health Regulations 2005.

By the following day, 30 August, 25 suspected cases of pneumonic plague had been notified to the health authorities from Arivonimamo district, Itasy region, including six deaths (three community deaths and three at Miandrandra health facility), 19 of which were admitted at Miandrandra health facility for treatment. A total of 20 samples (8 sputum and 12 blood) were collected the same day for laboratory confirmation at the Pasteur Institute of Madagascar.

As of 15 September 2021, a total of 20 suspected and 22 confirmed cases of plague have been notified. The median age of cases is 36 years (range 3 to 74 years), 22 cases are males and 20 are females. Reported cases are geographically located in two non-bordering regions: Itasy (3 affected municipalities in Arivonimamo district) and Haute Matsiatra (1 affected municipality in Ambalavao district). Both regions are known plague endemic areas, and during the 2017 outbreak they were highly affected with Ambalavao being the main epicenter.

Among confirmed cases, 19 have clinically presented as pneumonic plague and three as bubonic plague. Eight deaths occurred among confirmed cases (2 among bubonic plague cases and 6 among pneumonic plague cases) leading to a case fatality ratio of 37% (8/22). Of them, 4 were males and 4 females, 3 occurred in the community level and 5 at health facilities.

Read more at World Health Organization