Global Health: Deadly Plague Outbreak in Madagascar Appears to Wane
The large plague outbreak that began in Madagascar in August appears to be waning, according to government case counts and local news reports.
The outbreak has infected about 1,800 people so far, killing 127 of them.
A World Health Organization spokesman, Tarik Jasarevic, confirmed reports in Malagasy media that both deaths and new cases were declining and most hospitalized patients had recovered, although “we cannot rule out the possibility of further spikes.”
An Oct. 31 situation report from W.H.O.’s Africa region shows cases peaking in mid-October; Madagascar confirmed its first plague death by laboratory testing only on September 11.
The man thought to have triggered the outbreak — who was initially assumed to have malaria — died in August after he rode minibus taxis through two major cities, spreading the disease.
If the outbreak is under control, it will be a testament to the relatively rapid response by health authorities on the Indian Ocean island, assisted by the W.H.O., the International Red Cross, Unicef, Doctors Without Borders, Doctors of the World, the United States Agency for International Development, and other organizations.
The annual plague season typically peaks in December and lasts into April, but this year’s outbreak was unusual. Cases are usually concentrated in the rice-farming central highlands and spread by flea bites, producing in victims the swollen lymph glands of bubonic plague.
This year, most cases were in cities and of the pneumonic variety, which is spread by coughing.
The island’s director of health promotion, Dr. Manitra Rakotoarivony, said on local radio this week that there were “almost no more deaths,” Agence France-Presse reported. Daily bulletins from the National Office for Risk and Disaster Management bore that out.
Health authorities in Madagascar initially closed all schools, sprayed insecticide for fleas and banned public gatherings. Nine treatment centers were designated.
At roadside checkpoints all over the country, newly trained health workers boarded buses and taxis with thermometers to test passengers for fever. (The price for an infrared thermometer soared as high as $70, the AFP said.)
In cities, checkpoints were set up at banks and other buildings with heavy foot traffic.
Although many East African and Indian Ocean nations went on the alert, the only country with a confirmed case from Madagascar was the Seychelles.
Some alarmist news reports have suggested that the plague’s spread was driven by the Malagasy ritual of Famadihana, or the “turning of the bones.”
Relatives remove the bodies of their ancestors from family crypts, wrap them in new shrouds, catch them up on family gossip and dance with them. It usually occurs from July to September.
But medical experts dismissed the idea. The disinterred corpses are usually those of ancestors who died at least seven years previously. The withered remains do not attract fleas and, obviously, cannot cough.
Transmission could occur between live humans at the ceremonies, but they are far smaller than the sporting events, concerts and other gatherings that were banned to prevent the outbreak from spreading.