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The outbreak of plague in Madagascar that was first reported in November, and first identified in September 2014, is beginning to improve. As of 11 February 2015, a total of 263 cases, including 71 deaths, have been recorded. The worst affected area, the district of Amparafaravola in the central highlands, continued to report cases of pneumonic plague up to the 1st week of January 2015.
Plague is endemic in Madagascar and outbreaks have been reported annually since 1980. In the last three years, the number of cases has increased during the outbreaks. This current outbreak peaked between November and December 2014, however, the plague season normally runs until April.
Plague is an infection of wild rodents and is transmitted by fleas to other animals and humans. The risk to travellers is generally low, however, travel to plague endemic areas may be a risk, particularly if camping, hunting or having contact with rodents
In plague endemic areas contact with rodents should be discouraged. Travellers to these areas should be advised on how to store and dispose of food produce to prevent attraction to rodents. Avoidance of flea bites must be advised by use of repellents and insecticides. Travellers should also be discouraged from camping and handling rodents both dead or alive.
