Plague kills 94 in Madagascar, WHO says working to prevent spread

WHO's Africa emergencies director, Ibrahima Soce Fall, told reporters in Geneva the organisation was racing to stop both the Madagascar plague and an outbreak of the Ebola-like Marburg virus in Uganda that it was confident it could contain.

Plague is endemic in Madagascar, but the outbreak that has caused 1,153 suspected cases since August is especially worrying because it started earlier in the season than usual, it has hit towns rather than rural areas, and it is mainly causing pneumonic plague, the most deadly form of the disease.

The outbreak already looks big when compared with the 3,248 cases and 584 deaths reported worldwide from 2010 to 2015. Fall said the risk to Madagascar remained very high, although the international risk was very low.

WHO has delivered antibiotics to Madagascar to treat up to 5,000 patients and as a prophylactic dose for up to 100,000 people who might be at risk, as well as 150,000 sets of personal protective equipment.

About 2,000 health workers are tracing people who have had contact with plague sufferers, which should allow the disease to be controlled relatively quickly, Fall said.

"I'm confident that with the strong team we have on the ground, combined with more partners coming and health workers, we will be able very quickly to reverse the trend."

In Uganda, WHO hopes to halt an outbreak of Marburg, a highly infectious haemorrhagic fever similar to Ebola, which killed a 50-year-old woman on October 11, three weeks after her brother died of similar symptoms.

"The positive thing is that Uganda is very used to managing this kind of outbreak," Fall said. In the past decade, Uganda has already had four outbreaks of Marburg. An outbreak can kill up to 90 percent of the people who catch the disease.

Several hundred people may have been exposed to the virus at health facilities and at a traditional burial of the dead woman's brother, who worked as a game hunter and lived near a cave inhabited by Rousettus bats, natural hosts of the Marburg virus.

One suspected case and one probable case are being investigated.

"The teams have already investigated the area, identified potential contacts and monitoring these contacts. We are getting daily updates from the team, we are confident that... we will be able to contain it very quickly," Fall said.