World Health Organization Advisory: Plague in Madagascar: October 2017
As of October 4th, the Ministry of Public Health of Madagascar reports 194 cases of plague, including pneumonic, bubonic and once case of septicemia, with 30 deaths in 20 districts and cities across the country.
Implications for travelers:
The risk of infection with Yersinia pestis for international travelers to Madagascar is generally low. Plague is endemic in Madagascar where cases are reported every year. Due to current cases reported in several cities (including the capital Antananarivo) and the start of epidemic season (September to April) further spread is likely.
Madagascar is well linked by air both regionally and internationally. One visitor from the Seychelles who was participating in a basketball tournament was infected and died. Travelers to rural areas of plague-endemic regions may be at risk, particularly if camping or hunting or if contact with rodents takes place. In addition, travelers to previously non-endemic regions from where cases of pneumonic plague have been recently reported should avoid crowded areas, avoid contact with dead animals, infected tissues or materials, and avoid close contact with patients with pneumonic plague.
Travelers can protect against flea bites using repellent products for personal protection against mosquitoes, fleas and other blood-sucking arthropods. Travelers returning from Madagascar should seek immediate medical attention if they experience symptoms of fever, chills, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tinged sputum.
Based on the available information to date, the risk of international spread of plague appears very low. WHO advises against any restriction on travel or trade based on the available information about the plague in Madagascar.
Reference (NPR): http://www.npr.org/sections/goatsandsoda/2017/10/04/555338600/why-plague-season-is-a-big-worry-in-madagascar-this-year