‘Black death’ plague returns and claims 102 lives

South Africa is prepared for an outbreak of the ‘black death’ plague, also known as bubonic plague.

The latest World Health Organisation (WHO) situational report released on Friday, 20 October regarding the plague outbreak in Madagascar indicates that 1297 cases and 102 deaths, with a case fatality rate of 7 per cent, have been reported to health authorities there.

The majority of cases (65 per cent) are presenting as pneumonic plague, rather than the usual bubonic form.

A multisectoral national response coordination committee has been established, under the leadership of the Minister of Public Health (MOPH) with the support of the WHO, to co-ordinate the response to the plague outbreak.

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Enhanced contact tracing, improved surveillance and diagnostic capacity, restriction of public gatherings, infection prevention and control and community mobilisation are all underway.

In addition, since the recognition of the outbreak, the WHO has indicated that nine countries – South Africa, Mozambique, Tanzania, Ethiopia, Mauritius, Comoros, Seychelles and La Reunion – are at high risk for plague importation on account of trade and travel between Madagascar and these countries.

The latest WHO situation report may be found on the NICD website www.nicd.ac.za.

Since notification of the outbreak, the South African National Department of Health, with support from the NICD and the WHO country office, has been working together to ensure public safety.

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The following activities have been conducted: 

* All airline companies have been alerted to remain vigilant for suspected ill passengers. The Civil Aviation Authority has conducted refresher training for members in the event that suspected cases are identified.

* Port health officials have enhanced their screening measures to detect and respond to ill passengers arriving in the country.

* All provincial outbreak response teams have been alerted to enhance preparedness and implement response measures in the event that a case is detected in the country.

* Standard operating procedures for the management of a suspected case of plague have been circulated to stakeholders.

* The National Institute for Communicable Diseases has the laboratory capacity to diagnose plague and is actively supporting preparedness measures in the country.

South African travellers to Madagascar are advised to avoid highly populated areas and to wear surgical masks while in transit. Liberal application of DEET-containing insect repellent is advised to prevent flea bites. Prophylactic antibiotics are not advised.

All travellers returning from Madagascar must monitor their health for 15 days and seek medical care immediately at their nearest health facility if they develop fever, chills, head and body aches, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tainted sputum.

They should tell the doctor about their recent travel and their symptoms. Persons with fever should also be tested for malaria.