People who are planning to travel to Madagascar are advised to consult a travel doctor about means of preventing infection as the island country faces an outbreak of bubonic and pneumonic plague.
“The World Health Organization [WHO] notes that it is relatively common for Madagascar to experience cases of bubonic plague at this time of year, which is usually spread from animals to humans,” says Dr Pete Vincent of Netcare Travel Clinics and Tokai Medicross.
“This year, more cases of pneumonic plague have been recorded and the outbreak is affecting urban areas beyond the usual geographic pattern, which is of concern as this form of plague is passed from person to person through contact with infected bodily fluids and respiratory droplets.”
Dr Vincent says that while the chance of travellers contracting plague remains low, those planning to visit the country should familiarise themselves with the potential risks and measures that can be taken to keep themselves safe ahead of their departure.
According to WHO, there were 849 cases of plague, although not all were clinically confirmed, in Madagascar between 1 August and 15 October with a fatality rate of just under 8%.
“The South African National Institute for Communicable Diseases [NICD] recommends that anyone travelling to Madagascar avoid densely populated areas and contact with people who are ill. It is also advised that individuals wear surgical masks during travel to reduce the chance of pneumonic plague infection.
“Since the plague in its bubonic form is transmitted to humans by infected rodent fleas, people should do everything possible to prevent contact with rodents, and this includes animal carcasses,” Dr Vincent notes.
He advises using pesticides, such as Doom, to eliminate fleas in indoor areas, vehicles and camping equipment. “Another useful precaution against flea bites is the use of insect repellent fabric sprays, such as Permethrin. Insect repellent can be sprayed on collars, cuffs and the bottoms of long pants, as well as curtains, bedding and car seats to help deter fleas and mosquitoes alike.”
Dr Vincent warns that plague is potentially a life-threatening condition. Early symptoms of bubonic plague include painful inflammation of the lymph node, while the onset of pneumonic plague is often accompanied by fever, shortness of breath, coughing and weakness.
“Anyone who suspects they could have been exposed to infection or notices these symptoms while travelling in plague endemic areas should seek medical advice immediately, as early treatment can greatly improve the outcome,” he notes.
“Travellers should also not overlook the risk of malaria when visiting Madagascar, even though the media is at present highlighting the plague outbreak more prominently,” Dr Vincent warns.
“Malaria remains a very serious health risk to those visiting Madagascar. A visit to your local travel clinic in advance of your trip can ensure that you are protected with the prophylaxis and preventative measures most appropriate for you.”
Steps to prevent mosquito bites:
- Apply a good quality DEET (N,N-diethyl-m-toluamide) insect repellent.
- If you are wearing sun protection lotion, apply insect repellent after the sunscreen.
- Wear long-sleeved shirts and long pants. Mosquitoes are unlikely to bite on areas covered by clothing, particularly if the clothing is loose-fitting.
- Protect yourself with a mosquito net when sleeping. Remember to check that there are no rips in the fabric and ensure that you do not let the fabric rest against your skin, as mosquitoes could bite you through the netting.
Issued by: MNA on behalf of Netcare Travel Clinics and Tokai Medicross
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville and Pieter Rossouw
Telephone: (011) 469 3016
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