The Malagasy Red Cross is scaling-up community surveillance, contact tracing and communication in an effort to prevent further spread of a plague outbreak that has killed 30 people in Madagascar.

The outbreak started following the death in late August of a 31-year-old man in the central highlands where plague is endemic. 

In Madagascar, cases of bubonic plague-- spread between animals to humans through flea bites-- occur nearly every year. The bubonic plague bacterium can travel to a person's lungs, causing pneumonic plague, which can spread quickly from person to person through droplets in the air. Pneumonic plague--the most virulent strain of the bacteria-- is fatal if not treated early with antibiotics.

This is the first time that Pneumonic plague is spreading from person to person in non-endemic areas and in densely populated cities, including the capital Antananarivo

“This situation is worrying. Due to of the lack of immediate care in some parts of the country, this is the first time that pneumonic plague is spreading from person to person in non-endemic areas and in densely populated cities, including the capital Antananarivo,”” said Dr Fatoumata Nafo-Traoré, Regional Director for Africa at the International Federation of Red Cross and Red Crescent Societies (IFRC).

The urban spread of this outbreak has created panic across the country. To date there have been 194 cases of plague, 124 of which are of the pneumonic strain, across 20 districts in 10 regions. Public schools are closed and the Government had forbidden public gatherings to prevent further spread of the disease.

The Malagasy Red Cross has responded to past plague outbreaks in the country and is working closely with the Government and international partners to scale up response efforts. Malagasy Red Cross has mobilized 700 volunteers in response to the outbreak.

“Our volunteers are currently conducting surveillance, community mobilization and contact tracing,” said Andoniaina Ratsimamanga, Secretary General of Malagasy Red Cross. “We are also supporting waste management and fumigation.”

IFRC is releasing funds from its Disaster Relief Emergency Fund (DREF) to provide technical and financial support to response efforts on the ground and ensure that resources are at hand to bring in supplies and personnel to the affected area. Infectious disease and community-health experts will be deployed to Madagascar to support the Red Cross response.