Rapid Risk Assessment: Outbreak of pneumonic plague in Madagascar: recent introduction in the Seychelles

Madagascar has been experiencing an outbreak of plague since 23 August 2017, and 560 cases and 57 deaths (case fatality rate 10.1%) have been reported as of 12 October 2017. Of these cases, 394 are pneumonic plague, 143 bubonic plague, one is a septicaemic plague and the clinical presentation is undetermined for 22 cases. Cases have been mainly reported in the capital Antananarivo and the port city of Toamasina on the east coast. In addition, sporadic cases of pneumonic plague without apparent epidemiological links to the initial chain of transmission have been reported in several regions across the country.