In a related development, the European Centre for Disease Prevention and Control (ECDC) issued its first risk assessment on the outbreak, which said the outbreak's high number of pneumonic cases are concerning, especially since that form of the disease is known to spread in densely populated urban areas, such as its capital Antananarivo and port city of Toamasina, which are some of the main affected areas. During or after travel to Madagascar, travelers should be alert for symptoms of plague, and if they appear, seek medical care and inform the provider about their travel to Madagascar.
Stephen Morse, a professor of epidemiology who focuses on infectious disease at Columbia University told Newsweek that he agrees plague outbreaks such as these emphasize the importance of public health, and just what can happen when these measures are compromised. Unlike bubonic plague, which is spread through flea bites, pneumonic plague, an airborne illness, is spread through coughing.
This year urban areas have been affected, a development that has anxious aid agencies in a country not renowned for a robust healthcare system. Our teams are working to ensure that everyone at risk has access to protection and treatment.
It is unclear when the disease first broke out but the first death occurred on 28 August when a passenger died in a public service vehicle in the town of Moramanga, on the east coast.
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.
Eastern and central Madagascar have been worst hit by the outbreak, sparking emergency funding from the WHO.
How has the government reacted?
There have been concerted efforts to set up rat traps and spray insecticides in several neighbourhoods to prevent the spread of the disease.
Of the 230 new suspected cases reported since the WHO's Oct 4 update, 17 have proved fatal, the World Health Organization said.
What has been the reaction within the region?
Air Seychelles (HM, Mahé) has announced the suspension of flights to Madagascar following an outbreak of pneumonic and pulmonary plague on the Indian Ocean island that has thus far killed over seventy people.
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