Health advisory on plague in Madagascar (updated 12 December 2017)

Health Advisory: Plague
(12 December 2017)

1.     The Ministry of Health has been closely monitoring the situation in Madagascar, which had suffered an outbreak of pneumonic plague. The World Health Organization has since assessed that the epidemic phase of the outbreak in Madagascar was ending, as the number of new cases had steadily declined since mid-October 2017.

2.     On 25 November 2017, the Ministry of Health of Madagascar had announced that the pneumonic plague outbreak had been contained, i.e. there are very few new cases. However, because plague is endemic (occurs regularly) in Madagascar and the plague season lasts from September to April, more cases of plague can be expected to be reported until April 2018.

3.     While the period of heightened alert for plague in Madagascar has ended, travellers to plague-endemic countries are encouraged to maintain their vigilance and adopt the previously issued health precautions when overseas:

• Apply insect repellent to protect against flea bites;

• Avoid sick and dead animals;

• Avoid close contact with sick people especially those with cough or pneumonia;

• Avoid crowded areas where cases of pneumonic plague have been recently reported; and

• Observe good personal hygiene including frequent hand washing with soap and water.

4.     Travellers should immediately seek medical advice if they have been in contact with pneumonic plague patients or other high risk exposures in Madagascar, such as flea bites or direct contact with body fluids or tissues of animals. During or after travel to Madagascar, travellers who develop symptoms such as fever, headache, muscle ache, painful and inflamed lymph nodes, cough, shortness of breath, and blood-tainted sputum should wear a mask and seek medical attention promptly. They should inform the doctor of their recent travel to Madagascar.

Health Advisory: Plague

(7 November 2017)

       The Ministry of Health (MOH) is closely monitoring the outbreak of pneumonic plague in Madagascar. The risk of spread of plague from Madagascar to Singapore is assessed to be low.

2.     Nevertheless, travellers to Madagascar are encouraged to maintain their vigilance and adopt the following health precautions when overseas:

• Apply insect repellent to protect against flea bites;

• Avoid sick and dead animals;

• Avoid close contact with sick people especially those with cough or pneumonia;

• Avoid crowded areas where cases of pneumonic plague have been recently reported; and

• Observe good personal hygiene including frequent hand washing with soap and water.

3.     Travellers should immediately seek medical advice if they have been in contact with pneumonic plague patients or other high risk exposures in Madagascar, such as flea bites or direct contact with body fluids or tissues of animals. During or after travel to Madagascar, travellers who develop symptoms such as fever, headache, muscle ache, painful and inflamed lymph nodes, cough, shortness of breath, and blood-tainted sputum should wear a mask and seek medical attention promptly. They should inform the doctor of their recent travel to Madagascar.

4.     MOH continues to maintain close contact with the World Health Organization (WHO) and overseas counterparts to monitor the situation closely and ensure that public health is safeguarded. All hospitals have been alerted to stay vigilant against possible suspect cases. Our hospitals also have in place appropriate infection control measures. Suspect cases will be triaged at emergency departments and, as a precaution, isolated from other patients to minimise any risk of transmission.

About plague

Plague is caused by the bacteria Yersinia pestis, which spreads among rodents through infected fleas. Humans get infected with plague through bites of infected fleas, touching or skinning infected animals, or inhalation of infectious droplets. Plague is an endemic disease in Madagascar and cases are reported almost every year. The current outbreak of pneumonic plague, where spread human to human can occur, started in Madagascar in August 2017.

Last updated on 18 Dec 2017