World
Plague in Madagascar: the 2017 outbreak and why the country is endemic
Quick answer
- Madagascar is one of the countries where plague circulates endemically, especially in the central highlands.
- In 2017, the country experienced a predominantly pneumonic outbreak in urban areas, with around 2,300 cases and more than 200 deaths.
- The episode was contained with a rapid response: diagnosis, isolation, free treatment and contact tracing.
- It is an example of how urban plague outbreaks can occur — and how they can be stopped.
Why Madagascar is endemic
Plague reached Madagascar in the late 19th century, carried along maritime routes, and found favourable conditions to establish itself in nature: rodents, fleas and a rural environment with dwellings close to farmland. Since then, human cases have been recorded almost every year, mainly in the central highlands.
The bubonic form has historically predominated, linked to rural exposure. This makes the country one of the world's main foci of the disease and an important centre for surveillance and research.
The 2017 outbreak
In August 2017, a pneumonic plague case was identified in an urban area and, from there, the outbreak spread across cities, including the capital Antananarivo and the port of Toamasina. Unlike the usual rural, bubonic pattern, the episode was marked by person-to-person transmission.
| Aspect | Information |
|---|---|
| Predominant form | Pneumonic |
| Notified cases | Around 2,300 |
| Deaths | More than 200 |
| Affected areas | Including the capital and a port city |
| Outcome | Outbreak declared over in late 2017 |
How the outbreak was contained
- Rapid diagnosis and free treatment in health services.
- Isolation of pneumonic plague cases and respiratory precautions.
- Contact tracing and chemoprophylaxis.
- Restrictions on large gatherings and school measures in affected areas.
- International support and strengthening of reference laboratories.
The lesson
Even an urban pneumonic plague outbreak can be stopped when there is surveillance, agile laboratory diagnosis, isolation and contact management.
The situation today
Plague remains endemic in Madagascar, with cases notified in various years since 2017. Permanent surveillance and access to treatment are what keep the disease under control. For travellers, the risk on conventional urban itineraries is low, but precautions against fleas and rodents are recommended in rural areas.
Frequently asked questions
Does Madagascar have plague every year?
Plague is endemic in the country and cases are notified in most years, mainly in the central highlands. Most are the bubonic form, linked to rural exposure.
What was the 2017 outbreak?
It was a predominantly pneumonic plague outbreak in urban areas, with around 2,300 cases and more than 200 deaths, declared over in late that year after an intensive response.
Why was the 2017 outbreak different?
Because it occurred in cities and involved person-to-person transmission (pneumonic form), instead of the usual rural, bubonic pattern.
Is it dangerous to travel to Madagascar?
The risk for the average traveller is low, especially on urban itineraries. In rural areas, avoid contact with rodents and fleas and follow local health guidance.
Sources
Medical review
Review by a licensed health professional is being arranged. This educational content is based on reference sources (WHO, CDC and medical literature) and does not replace evaluation, diagnosis or treatment by a health professional.
How this content was produced
- Who
- Produced by the Equipe editorial do Peste.com.br, the editorial team responsible for gathering, verifying and classifying public information about plague (Yersinia pestis).
- How
- Information is compiled from official and scientific sources (WHO, CDC and national health authorities) and from recognised news outlets. Every statement is classified as confirmed, reported or unconfirmed, and each article lists its sources.
- Why
- To offer clear, source-based information in Portuguese about plague and to separate verified fact from rumour. This content is educational and does not replace medical advice.
- Medical review
- Review by a licensed health professional is being arranged; no credential is claimed until a real professional is credited.
- Last review
See our sources and methodology and the editorial team.A revisão por profissional de saúde habilitado está em processo de credenciamento. Assim que concluída, o nome e o registro serão informados nesta página e nos dados estruturados.