The number of new plague cases in Madagascar has steadily declined since mid-October. From 6 to 15 November 2017, 149 probable (12) and suspect (137) pneumonic cases, 18 bubonic cases and 8 unspecified cases of plague have been reported to WHO.

Yersinia pestis bacteria, which was grown on a medium of sheep’s blood agar (SBA) Image/CDC

The date of onset of the last case of bubonic plague was Oct. 29 and the last confirmed case of pneumonic plague was reported on Nov. 6.

While the number of new cases and hospitalizations are declining, evidence suggests that the epidemic phase of the outbreak is ending. However, WHO anticipates plague cases to be reported until the endemic plague season ends in April 2018.

From 1 August to 15 November 2017, a cumulative total of 2,203 confirmed, probable and suspected cases of plague, including 192 deaths (case fatality rate 9%), have been reported from 56 of 114 (49%) districts in Madagascar. Analamanga Region in central Madagascar has been the most affected, with 68% of all recorded cases. Since the beginning of this outbreak, the vast majority of cases have been treated and have recovered. As of 15 November 2017, only 6 people were hospitalized for plague.

There has been no international spread outside the country.