Madagascar plague: mitigating the risk of regional spread


Two women and two men discussing, at a port in Seychelles

A WHO workforce monitor plague surveillance efforts at a seaport in Seychelles along with the nation’s Ministry of Health. Seychelles has not had any confirmed instances of plague however is rising preparedness given its proximity to Madagascar and the robust ties between the 2 Indian Ocean nations.

WHO/E. Musa

This 12 months plague got here early to Madagascar and unfold rapidly. When it started to maneuver out from the areas the place it historically happens, individuals grew to become more and more alarmed – each inside the island nation and in neighbouring territories and international locations.

From August to late October 2017, greater than 1800 suspected, possible or confirmed plague instances have been reported, leading to 127 deaths. This outbreak is unusually extreme, and there are nonetheless 5 extra months to go earlier than the top of the plague season.

WHO has acted rapidly, releasing funds and sending specialists and provides to Madagascar, whereas supporting neighbouring international locations to scale back the danger of regional unfold.

Being able to act, stopping panic

Plague is without doubt one of the oldest – and most feared – of all illnesses. Historically, plague has been accountable for widespread pandemics with excessive mortality. It was often known as the “Black Death” throughout the fourteenth century, inflicting greater than 50 million deaths in Europe.

Nowadays, plague is definitely prevented and handled with antibiotics if detected early sufficient, and an infection could be prevented by way of using customary precautions.

“An outbreak of plague no longer unfolds in the manner portrayed by our history books,” mentioned Dr Sylvie Briand, Director of WHO’s Infectious Hazard Management Department. “Plague is an old disease, but the challenges it poses today are contemporary and fundamentally different from what we had even 40 years ago.”

Despite the relative ease of therapy, plague’s affiliation with the Black Death weighs closely on the favored conscience – and is commonly cited in media reviews and tabloid headlines about outbreaks.

So it is very important strike a steadiness between encouraging international locations within the area to be able to act in case of an outbreak, whereas avoiding panic that might end in pointless or counterproductive measures resembling commerce restrictions or journey bans on affected international locations.

Assessing danger

Days after being alerted to the plague outbreak in Madagascar, WHO carried out an evaluation to find out the danger of additional unfold. Taking under consideration the nation’s capacities and vulnerabilities, the evaluation discovered that the general danger of additional unfold on the nationwide degree was excessive, on the regional degree was average, and on the international degree was low.

WHO moved rapidly to badist the Government of Madagascar to reply to the outbreak, whereas on the identical time working with close by international locations and territories.

Neighbouring Comoros, Mauritius, Mozambique, Reunion and Mayotte, Seychelles, South Africa, and the United Republic of Tanzania have been prioritized for elevated plague preparedness and surveillance. WHO has additionally helped Ethiopia and Kenya to boost preparedness ranges due to their direct airline connections with Madagascar.

Improving exit screening in Madagascar

When WHO started to extend badist for the Malagasy Government’s response to the outbreak, one of many first locations they went was the capital’s worldwide airport. A WHO workforce suggested on putting in extra sturdy and visual public well being measures.

The strengthened exit screening system gives details about plague to all travellers, screens pbadengers by way of temperature checks and medical questionnaires, and consists of procedures to isolate and deal with symptomatic pbadengers.

“The exit screening process tracks pbadengers from the moment they enter the airport until they board a flight. We also provided information to airline companies and spoke to airport medical personnel. We explained the disease, the risks, and how they can be prepared,” mentioned Dr Briand.

Strengthening regional plague preparedness

For the 9 precedence regional international locations and territories, step one was to determine weak factors in preparedness and operational readiness. WHO labored with nationwide well being authorities to finish a plague preparedness guidelines to evaluate their readiness, and to determine concrete actions to bridge gaps.

The guidelines badesses nationwide coordination mechanisms, and logistical, epidemiological, and laboratory surveillance capabilities. It verifies that Rapid Response Teams are able to deploy, that danger communication and group engagement methods are ready, and that preparedness measures are in place at factors of entry.

If gaps are recognized, fast steps are taken to handle them. In Seychelles, WHO supported laboratory testing of suspected instances, deployed specialists and medical provides, and offered steerage for the tracing and therapy of contacts of individuals suspected to be contaminated.

In Mauritius, along with finishing the guidelines, WHO helped to handle considerations in regards to the excessive variety of direct flights between Madagascar and Mauritius by supporting the Health Minister to speak the measures being taken to strengthen plague preparedness in any respect ranges.

WHO logistics groups additionally prepositioned gear and provides – together with private protecting gear (PPE), antibiotics, and different gear required to securely determine plague instances – in Comoros, Mauritius, Mozambique, and the United Republic of Tanzania.

Sustaining preparedness for well being safety

The fast and coordinated efforts to strengthen plague preparedness have additionally helped construct regional outbreak response capability extra usually.

“We’ve accomplished a great deal in a short time, and helped to strengthen overall regional health security,” mentioned Dr Ibrahima-Soce Fall, WHO Regional Emergencies Director for the WHO African Region.

“But to ensure longer-term sustainability, we have to provide continuing support for Madagascar’s health system to better anticipate, detect, and respond to future plague outbreaks. Supporting these efforts improves health security for everyone.”

A coordinated strategy

Through its Health Emergencies programme, monetary badist for WHO’s response to the plague outbreak in Madagascar has been offered by the WHO Contingency Fund for Emergencies (CFE) and the governments of Italy and Norway.

The International Federation of the Red Cross and Red Crescent Societies, in addition to the Malagasy National Society, the Institute Pasteur, Médecins Sans Frontières (MSF), UNICEF, the United States Centers for Disease Control and Prevention (CDC), Santé publique France, the Global Outbreak Alert and Response Network (GOARN) and different companions are actively supporting the federal government and well being authorities in Madagascar.

WHO has offered technical and operational badist in a variety of areas from coordination and planning to surveillance, case administration, group engagement, logistics, and extra.

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