Headlines - Plague Outbreak in Madagascar

Plague is an infectious disease caused by the bacterium Yersinia pestis. It is transmitted from small wild mammals, which serve as reservoirs, via fleas that parasitize them. In humans, it generally occurs after a bite from fleas on rats infected with the bacterium and most often results in the bubonic form (80 to 95% of cases). Human infection can also occur via the respiratory route, through close contact with a patient suffering from pneumonic plague, by inhaling droplets containing bacteria emitted when the patient coughs. This form is highly contagious and is the deadliest if left untreated. The plague is found primarily in Africa, Asia, and the Americas. Madagascar and the DRC are the countries with the highest endemicity, with numerous cases reported each year. France has been free of the disease since 1945. On August 23, 2017, the WHO reported a plague epidemic in Madagascar that differed from previous seasons due to a high number of cases with a significant proportion of pneumonic forms and an unusual geographic distribution (densely populated cities and affected coastal tourist areas). As of October 24, 2017, 1,309 cases (suspected, probable, and confirmed) of plague had been recorded, including 93 deaths (a case fatality rate of 7%). Of these cases, 882 are pulmonary forms (representing 67.4% of cases). The risk of importing a case of pulmonary plague into the national territory remains low, both for the French departments in the Indian Ocean and for mainland France. No imported cases of plague have been diagnosed to date on French territory. However, in this context, any suspected case of plague in a person who has returned from Madagascar within the last 7 days must be reported to SAMU-Centre 15 and the ARS so that appropriate care can be arranged. French nationals planning to travel to Madagascar are advised to seek information before departure.