Patients in quarantine at a plague treatment center in Toamasina, Madagascar. The outbreak appears to have peaked. (Credit: Rijasolo/Agence France-Presse — Getty Images)

Patients in quarantine at a plague treatment center in Toamasina, Madagascar. The outbreak appears to have peaked. (Credit: Rijasolo/Agence France-Presse — Getty Images)

The large plague outbreak that began in Madagascar in August appears to be waning, according to government case counts and local news reports.

The outbreak has infected about 1,800 people so far, killing 127 of them.

A World Health Organization spokesman, Tarik Jasarevic, confirmed reports in Malagasy media that both deaths and new cases were declining and most hospitalized patients had recovered, although “we cannot rule out the possibility of further spikes.”

An Oct. 31 situation report from W.H.O.’s Africa region shows cases peaking in mid-October; Madagascar confirmed its first plague death by laboratory testing only on September 11.

The man thought to have triggered the outbreak — who was initially assumed to have malaria — died in August after he rode minibus taxis through two major cities, spreading the disease.

If the outbreak is under control, it will be a testament to the relatively rapid response by health authorities on the Indian Ocean island, assisted by the W.H.O., the International Red Cross, Unicef, Doctors Without Borders, Doctors of the World, the United States Agency for International Development, and other organizations.

The annual plague season typically peaks in December and lasts into April, but this year’s outbreak was unusual. Cases are usually concentrated in the rice-farming central highlands and spread by flea bites, producing in victims the swollen lymph glands of bubonic plague.

This year, most cases were in cities and of the pneumonic variety, which is spread by coughing.

Click here to continue reading…

SOURCE: DONALD G. McNEIL Jr. 
The New York Times