The latest World Health Organisation (WHO) situational report (No. 5) released on 20th October 2017 regarding the plague outbreak in Madagascar indicates that 1297 cases and 102 deaths (case fatality rate of 7%) have been reported to health authorities there. The majority of cases (65%) are presenting as pneumonic plague, rather than the usual bubonic form.
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.