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Plague outbreak ending but not over yet |23 November 2017

• Local measures still in place

 

Although the epidemic phase of the plague outbreak in Madagascar is ending, it is not over yet, the World Health Organisation (WHO) has warned.

Therefore, all measures in place in Seychelles continue, including the temporary suspension of Air Seychelles flights to Madagascar, active isolation, measures at the ports of entry, surveillance at all levels.

 

Overview of the plague outbreak

The plague outbreak in Madagascar started in August 2017 but was first officially reported by the WHO on September 28, 2017. Since the onset 2267 cases have been reported with 195 deaths (case fatality rate of 9%). 76% of the total number of cases were pneumonic form of plague. During the outbreak 82 healthcare workers got infected but none died.

It is worth noting that the only two foreigners who contracted the plague were the late Alix Alisop (Seychellois) and a South African coach who was one of his contacts when he was ill. The latter recovered.

The number of new plague cases in Madagascar has steadily declined since mid-October.

 

 

 

The number of new cases and hospitalisations of patients due to plague has been declining and the last confirmed bubonic case was reported on November 7 and the last confirmed pneumonic case was reported on November 14, 2017.

Since plague is endemic to parts of Madagascar, WHO expects more cases to be reported until the typical plague season ends in April 2018. It is therefore important that control measures continue through to the end of the plague season. With all the measures in place it is expected that any new cases would be managed more promptly.

The risk of international spread is mitigated by the short incubation period of pneumonic plague, implementation of exit screening measures and advice to travellers to Madagascar, and scaling up of preparedness and operational readiness activities in neighbouring Indian Ocean islands and other southern and east African countries.

 

Seychelles context and update

WHO update of November 20 has declared that the epidemic phase of the outbreak is ending but not over. WHO would usually declare the outbreak to be over after two maximum incubation periods has passed. (2x7=14 days). However, given the endemic status of plague in Madagascar and given that the usual season ends in April, they may not do that just yet.

Therefore, all measures in place in Seychelles continue, including the temporary suspension of Air Seychelles flights to Madagascar, active isolation, measures at the ports of entry, surveillance at all levels.

In view of the greatly decreased risk of human to human transmission, limited disease circulation exit screening in Madagascar, entry screening in Seychelles, easy treatment of cases, no antibiotic resistance detected and confirmatory tests can now be done locally, completed preparedness and response plan including a communication plan, make the chance of a plague case entering Seychelles and spreading very low at this stage.

The Public Health Authority will provide at least weekly update as Madagascar enters the tail end of the outbreak.

 

Contributed

 

 

 

 

 

 

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