Plague in Madagascar
Updated: April 10, 2018
- The risk level was reduced to level 1. Information on airport screening was removed.
Original publication date: October 13, 2017
What is the situation in Madagascar?
From August to November 2017, Madagascar experienced a serious outbreak of pneumonic plague. On November 27, the World Health Organization (WHO) reported that this outbreak has been contained. It is expected that cases of plague will continue to be reported in Madagascar. Cases are expected to be mostly bubonic plague as bubonic plague is reported nearly every year between September and April in Madagascar.
What is plague?
Plague is a disease caused by the bacteria Yersinia pestis. This bacteria is usually found in small animals (including rats, squirrels and other rodents) and in fleas that feed upon infected animals.
You can become infected with plague through:
- the bite of a flea infected with the plague bacteria
- direct contact with infectious tissues or fluids while handling an animal or human that is sick with or that has died from plague
- breathing of respiratory droplets from an animal or human with pneumonic plague.
There are three types forms of illness that the infection can cause:
- Bubonic plague is the most common form of plague. Infection of the lymph nodes by the plague bacteria (referred to as buboes) causes them to swell and become painful. This form of plague usually occurs from bites of infected fleas.
- Septicemic plague occurs when the infection spreads through the blood. It can cause bleeding, and can also cause skin tissue to turn black, especially on fingers, toes, and the nose. This form results from bites of infected fleas or from handling infected animals.
- Pneumonic plague is the most serious form of plague. Pneumonic plague is caused by breathing in droplets from the cough of an infected person or animal. It is also caused by untreated bubonic or septicemic plague bacteria that spread to the lungs. It is the only form of plague that can be spread from person to person via droplets in the air.
What are the symptoms of plague?
Symptoms of plague can appear one to seven days after contact and they can vary depending on the form of plague. They are usually flu-like and can include the following:
- weakness and headache
- shortness of breath, chest pain, cough and bloody/watery mucous
- painful and swollen lymph nodes (buboes)
- muscle pain
- nausea, vomiting
- diarrhea, abdominal pain
Is there a vaccine or treatment for plague?
At this time, there is no plague vaccine available in Canada for travellers.
All forms of plague can be effectively treated with antibiotics if diagnosed early. If left untreated it can progress rapidly to death.
How can you protect yourself from plague?
Before you travel you should:
Consult a health care professional or visit a travel health clinic preferably six weeks before you travel.
During your trip:
Protect yourself from flea bites while travelling to Madagascar.
- Use insect repellent on exposed skin
- Cover up: wear light-coloured, long–sleeved shirts and long pants
Avoid contact with:
- rodent nests and burrows as these could contain fleas
- sick or dead animals
- close contact with persons who are sick or persons suspected to be infected with pneumonic plague
- crowded areas where pneumonic plague have been recently reported
- bodies of people who died of plague or unkown illnesses, including during funeral or burial rituals
If you have had contact with someone with pneumonic plague, you should immediately contact a health care professional. You may need antibiotics to prevent infection.
Wash your hands frequently:
- Wash your hands often with soap and water for at least 20 seconds.
- Use alcohol-based hand sanitizer if soap and water are not available. Keep a bottle with you when you travel.
Health care workers that may come into contact with someone with pneumonic plague:
- should practise strict infection prevention and control measures including the appropriate use of personal protective equipment
- take antibiotics to prevent infection
While you are in Madagascar, or returning to Canada:
Monitor your health:
If you develop symptoms of plague:
- See a health care professional immediately, whether you are abroad or at home. Tell them about your symtoms and about your travel to Madagascar.
- If you start feeling sick on the way home, tell a flight attendant or border services officer when entering Canada. They will notify a quarantine officer who can assess your symptoms.
Stop the spread of germs.
- You should not travel if you are ill, or have been in contact with someone who shows symptoms or has been diagnosed with plague.
- Avoid close contact with other people.
- Cover your mouth and nose with your arm when you sneeze or cough.
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