While Madagascar experiences outbreaks of the plague, also known as the Black Death, in rural regions nearly every year, the country is experiencing an unusually alarming outbreak affecting major urban centers, including the nation’s capital and its major port city of Toamasina. Direct Relief sent a shipment this week full of protective gear, IV fluids and other items requested by health professionals working to treat the disease and prevent its spread.

Between Aug. 1 and Oct. 30, 2017, 1,801 suspected cases were reported across the country, including places where plague is not usually seen. Of the confirmed and suspected cases, at least 127 have resulted in death, with numbers continuing to rise.

The plague is an infectious disease caused by the bacteria Yersinia pestis and presents in humans in three forms: bubonic (the most common form; infects the lymphatic system and is usually spread when an infected rodent or flea bites a person), septicemic (when the bacteria enters the bloodstream), and pneumonic (when the bacteria spreads to the lungs).

While bubonic plague is the most common form, the current outbreak has been mostly pneumonic cases. This is particularly alarming since the pneumonic form is the most lethal of the disease and spreads easily from person to person.

Pneumonic plague’s incubation period is 1 to 3 days, and if untreated, can be rapidly fatal. Antibiotics and supportive therapy, including IV fluids, are effective if a patient is diagnosed and treated quickly. Antibiotics can also be effective in preventing spread of plague if taken by those who have been in contact with someone diagnosed or suspected to have the plague. Personal protective equipment is also crucial for healthcare workers treating patients with confirmed or suspected cases.

Direct Relief is working directly with the Ministry of Public Health and the United Nations Population Fund Madagascar office to support plague centers and maternity centers in the regions of Analamanga and Atsinanana. Nine pallets of personal protective equipment, needles, syringes, IV fluids, and additional medicine and supplies are en route and will be arriving in the country on Sunday.

Direct Relief has historically partnered with UNFPA Madagascar to support district and regional hospitals in Madagascar, providing fistula repair services with Direct Relief’s Fistula Repair Modules.