Outbreak of urban pneumonic plague in Madagascar in 2017: responses, challenges, lessons learned
Tracks
Meeting Room 1.40
| Wednesday, July 2, 2025 |
| 3:00 PM - 3:30 PM |
Overview
Speaker: Prof Mamy Randria
Speaker
Prof Mamy Jean de Dieu Randria
University Hospital of Antananarivo
Outbreak of urban pneumonic plague in Madagascar in 2017: responses, challenges, lessons learned
Abstract
In 2017, there was an outbreak of urban pneumonic plague in Madagascar that affected the country's largest cities.
Our aim is to describe the overall management of the response to this outbreak in Madagascar and report on the difficulties and lessons learned from this outbreak.
When the pneumonic plague epidemic was declared, case definitions were drawn up and then disseminated. The patient circuit (suspect, probable and confirmed) was also drawn up.
Health facilities were prepared. Human resources were trained in the diagnosis and treatment of cases of plague, as well as in infection prevention and control (IPC) measures.
Cases were treated in busy hospitals, which received the first cases in spite of themselves. These centres were obliged to review the patient flow within their walls to avoid contaminating ‘non-plague’ cases and healthcare professionals: a pre-sorting system was put in place to quickly separate suspected cases from non-suspect cases. There were two different triage rooms and two hospital wards for non-suspect patients and for suspected and confirmed plague cases. Non-suspect cases followed the usual circuit. Suspected cases were managed in the plague triage area, where rigorous IPC measures were taken to prevent transmission of the disease between suspected cases and between suspected and confirmed cases.
Many challenges were encountered during this epidemic, and many lessons were learned as well. Somehow,this outbreak represented a great opportunity to learn more about the plague, which remains a potential threat to humanity, especially in its pulmonary form.
Our aim is to describe the overall management of the response to this outbreak in Madagascar and report on the difficulties and lessons learned from this outbreak.
When the pneumonic plague epidemic was declared, case definitions were drawn up and then disseminated. The patient circuit (suspect, probable and confirmed) was also drawn up.
Health facilities were prepared. Human resources were trained in the diagnosis and treatment of cases of plague, as well as in infection prevention and control (IPC) measures.
Cases were treated in busy hospitals, which received the first cases in spite of themselves. These centres were obliged to review the patient flow within their walls to avoid contaminating ‘non-plague’ cases and healthcare professionals: a pre-sorting system was put in place to quickly separate suspected cases from non-suspect cases. There were two different triage rooms and two hospital wards for non-suspect patients and for suspected and confirmed plague cases. Non-suspect cases followed the usual circuit. Suspected cases were managed in the plague triage area, where rigorous IPC measures were taken to prevent transmission of the disease between suspected cases and between suspected and confirmed cases.
Many challenges were encountered during this epidemic, and many lessons were learned as well. Somehow,this outbreak represented a great opportunity to learn more about the plague, which remains a potential threat to humanity, especially in its pulmonary form.
Biography
Specialist in Internal Medicine and Professor of Infectious Diseases and Lecturer and researcher at the University of Antananarivo and University of Mahajanga, and Diego-Suarez
Head of the Unit of Infectious Diseases at Antananarivo University Hospital for twenty years. Director of the Befelatanana University Hospital for ten years (2010-2020). Founding President of the Malagasy Society of Infectious Diseases and the Malagasy Society of Infection and Prevention Control (SNPCI/Wash) since 2019. Chairman of the Nosocomial Infection Control Committee at CHU Befelatananana. Involved in the management of various outbreaks and pandemics in Madagascar.
Highly involved in the promotion of IPC and the proper use of antibiotics, and fight against antibiotic resistance. President of the review committee of the guidelines on antibiotic therapy in Madagascar. Close collaborator of UNAIDS, WHO and the Ministry of Health in Madagascar for various subjects. International WHO Consultant (Mauritania) during the COVID-19 pandemic. Member of ICAN since 2019 and member of the ICAN board and executive committee since 2024. Main areas of interest: HIV infection, tuberculosis, PCI/ Wash, and Antibiotic resistance. Authors of some sixty publications on infectious diseases/HIV, and IPC
