January 11, 2019

Plague death toll close to 100 in Madagascar as stigma curbs containment efforts

Related Story: Plague outbreak kills 40 in Madagascar: WHORelated Story: A timeline of the Ebola outbreak

The death toll from the plague which is spreading in Madagascar has risen close to 100, and the Red Cross has warned that growing stigma attached to the disease could undermine efforts to contain the outbreak.

Key points:

  • Bubonic plague common in Madagascar but this year's epidemic is worst this century
  • There are 911 cases recorded across 17 regions since August
  • Can be transmitted through air or infected flea bites

While cases of bubonic plague occur in Madagascar nearly every year, this year's epidemic is "much more dangerous", secretary general of the International Federation of Red Cross and Red Crescent Societies (IFRC) Elhadj As Sy said.

Plague arrived earlier than expected this year and has become much more contagious as it is now being transmitted from person to person through the air in its pneumonic form, as well as from animals to humans through infected flea bites in its bubonic form.

The infection is also spreading in urban centres and in areas that until now had not been affected, the World Health Organisation (WHO) said this week.

IFRC staff on the ground say panic is exacerbating the stigma around the plague, Mr Sy said.

"There is a risk this could drive people underground and that may result in us losing some of the contacts we are tracing in order to contain the outbreak," he warned.

"Our volunteers are working in communities convincing people to seek help."

The Red Cross is using burial practices that avoid contact with corpses, and deploying medical staff and equipment to help Madagascar tackle its worst outbreak of the plague this century.

The latest figures from Madagascar's health ministry show there have been 911 recorded cases of the plague across 17 of the island nation's regions since August, killing 97 people so far.

The number of cases was growing by the day, Mr Sy said, adding that the seriousness of the outbreak required "great vigilance."

Lessons learnt from West Africa Ebola epidemic

Uniformed Red Cross volunteers speak to villagers.

The IFRC has introduced the same "safe and dignified" burial methods used in West Africa during the 2014-2016 Ebola epidemic, which are also being followed by the WHO and local government authorities to limit the spread of the plague.

Experience has shown such practices cut the chain of transmission by preventing further infections through direct contact with corpses, while enabling families and relatives to bury their dead in line with local customs.

Hospitals in Madagascar are on high alert and are implementing preventative measures such as limiting visitor numbers, medical staff said.

The IFRC, WHO and other international agencies are also providing ambulances to ensure patients with suspected cases do not spread the virus by taking crowded buses and taxis.

Another focus is on improving community surveillance, so as to detect infections earlier.

Mr Sy said building partnerships and trust at the community level is critical, as well as reinforcing an existing referral system for suspected cases.

But overcoming the plague will require longer-term assistance, he emphasised.



Original Article

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