A child in Madagascar.

Plague epidemic in Madagascar

Action Against Hunger is working with communities, health authorities and international agencies to prevent and control infection.

By Action Against Hunger News

Oct 20 2017

Since the beginning of August 2017, cases of lung plague have been on the rise in Madagascar. Although the disease is endemic in the country, 846 cases have been recorded in two and a half months, double the usual annual number. Worryingly, the type of plague detected is mainly the pulmonary form: without proper treatment, the outcome is fatal. 

"The plague is endemic in Madagascar, it re-emerges every year but generally it is bubonic plague (not transmissible from one human being to another), which develops in rural areas. The peculiarity of this epidemic is that today we are faced with a highly transmissible lung plague, which is rife in urban areas where all the conditions are in place for the epidemic to spread," says Olivier, Action Against Hunger’s Country Director in Madagascar. 

Since 2011, our teams have been fighting undernutrition in the slums of Antananarivo and in the south of the country. Taking advantage of our strong presence in these neighbourhoods, we have deployed a community approach to bolster the knowledge and understanding of the local population to help protect themselves from the disease and to seek help if needed.  Our teams are now working in two hospitals in the capital to assist medical teams deal with this health emergency.


"The symptoms of lung plague are very close to an influenza-like condition, making it difficult to identify at first sight. Incubation takes one to three days. People experience high fever, headaches, generalised weakness and chest pain that progress to severe pneumonia. In 48 hours, without proper treatment, the outcome is fatal," says Caroline Antoine, a health worker at Action Against Hunger. 


Identifying infected individuals is one of the major challenges in controlling the epidemic. It is essential to be able to trace patients' movements and find out whom they have met in order to reduce the risk of contamination.

Our teams are working with health authorities and international agencies to set up protocols for the protection and control of infection, particularly in health facilities. Training of health personnel, setting up of handwashing stations, disinfection of premises, management of contaminated waste and waste water are all measures that reduce risks and help health centres in their management of patients.

Raising awareness and supporting communities to prevent a worsening of the situation.

"The epidemic is ahead of us," explains Olivier. "We have not yet reached the peak. The spread has been so rapid that awareness is taking time, but there has been an improvement in measures taken. Since this weekend, we have been starting to see ambulance drivers wearing protective masks, something we didn't see last week."

Beyond medical care, the challenge in the future will be to support communities to fight the epidemic, but also to provide psychological support to infected people and their families. 


"Thanks to our experience of the Ebola epidemic in West Africa and the management of cholera outbreaks in several of the countries where we work, we have developed real expertise in supporting families, an expertise which will be put to use in the coming weeks. Being confronted with an epidemic often provokes strong emotional responses and destabilises social and family ties: these are normal responses to an unusual situation, for example, fear, anger, grief and stigmas associated with the epidemic," adds Caroline Antoine.


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Photo Credits: © Pierrot Men – Madagascar and © Action Contre le Faim – Madagascar