The World Health Organization has issued a warning about the plague outbreak now sweeping the African island of Madagascar. The new cases lift the outbreak's number of suspected, probable, and confirmed cases to 387 and the number of deaths to 45. Travelers who have had close contact with people with plague pneumonia or other high-risk exposures should immediately notify a health care provider. It is considered the most deadly form of plague and can kill someone in less than 24 hours.
The more common - and more commonly known - bubonic plague, which was responsible for the "Black Death" in medieval Europe, is passed to humans from fleas.
If found in time the plague is curable, and teams are working to ensure those at risk can gain access to protection as well as treatment.
The medicines are being distributed to health facilities and mobile health clinics across the country with the support of the Ministry of Health and partners.
The WHO is also supporting preparedness activities in seven high-risk countries that took part in a recent basketball tournament and have trade and travel connections to Madagascar: South Africa, Mozambique, Tanzania, Mauritius, Comoros, Seychelles, and Reunion.
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The outbreak of plague in Madagascar continues to evolve. Prime Minister Olivier Mahafaly Solonandrasana banned all public gatherings in Antananarivo on September 30th, the BBC reported, and later closed down universities and public schools on October 5.
A Seychellois basketball coach died in a hospital in Antananarivo on 27 September during the Indian Ocean Basketball Championship.
There are three types of plague - bubonic affecting the lymph nodes, septicaemia which causes bleeding under the skin, and pneumonic which affects respiration. Fleas pick up the plague-causing bacteria Yersinia pestis from small mammals like rodents. Though instances of plague are not uncommon on the island, which usually sees around 400 cases a year, the ongoing epidemic involves mostly cases of pneumonic rather than the more common bubonic plague - and that airborne variety of the disease is significantly more transmissible and deadly.
Jocelyne Razafiarivony, from the Mothers' Union in Madagascar, commented: "We pray day and night that God would preserve Malagasy people from disease".
Those traveling to Madagascar should use insect repellent to avoid flea bites, avoid close contact with sick and dead animals, and avoid close contact with sick people, especially those with cough or pneumonia.