Further to Current note 51/4002 (at http://www.hps.scot.nhs.uk/ewr/redirect.aspx?id=75886), the European Centre for Disease Prevention and Control (ECDC) has issued an epidemiological update on the epidemic of plague ongoing in Madagascar.
As of 20 October 2017, the World Health Organization (WHO) has reported 1,365 cases and 106 deaths (representing an 8% case fatality rate). ECDC notes as a matter of concern that 915 cases (67%) are of pneumonic plague. This high proportion of pneumonic plague indicates that droplet transmission is a driver of the spread of plague in Madagascar beyond the areas that have been considered as endemic for bubonic plague to date. In the last weeks, however, the numbers of new confirmed cases seem to be levelling off, indicating that the outbreak is gradually being controlled.
To date, none of the suspected cases of plague investigated outside Madagascar have been confirmed in relation to this outbreak. The update and a range of guidance materials can be accessed at https://ecdc.europa.eu/en/news-events/epidemiological-update-plague-madagascar.