Plague outbreak kills 133 in Madagascar

The spread of a plague outbreak in Madagascar may finally be slowing down.

The epidemic, which began in August, has taken the lives of 133 people and resulted in 1,836 suspected or confirmed cases.

However, the occurrence of new cases is finally decreasing, according to a report released Wednesday by the United Nations Office for the Coordination of Humanitarian Affairs.

The week of October 9, there were 477 new cases, compared with 161 during the week of October 23. The report says 1,044 patients have been cured, and 83 others are receiving treatment.

The number of hospitalizations because of the plague has also decreased, according to the World Health Organization.

Although the number of total cases has continued to increase, this is because of "enhanced surveillance and ongoing investigations," the WHO said; some of the cases were not actually infected, upon inspection.

The epidemic remains active in 12 districts, and among the total cases reported, 61% are said to be the pneumonic plague, according to the UN office.

This is faster-spreading and more transmittable than bubonic plague, noted Tarik Jasarevic, a spokesman for the WHO; "compared with past outbreaks, this year there is a higher portion of pneumonic plague cases."

Since plague is endemic (or regularly found) in Madagascar, its "spread to non-endemic areas which were not used to handling plague cases, including densely populated cities," may have caused a more severe outbreak, according to Jasarevic.

The unusual spread of pneumonic plague in this outbreak was due to one infected person who traveled to find care early in the outbreak, infecting people along the way. These individuals infected others, leading to several chains of transmission, added Nyka Alexander, a representative of the WHO Health Emergencies Programme.

Ongoing efforts to control the spread of bubonic and pneumonic plague include seeking out and treating new cases, identifying the method of disease contact, disease follow-up and antibiotic treatment, rodent and flea control, and "safe and dignified burials," the WHO said in a statement.