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CHP alerts travellers to plague outbreak in Madagascar
     The Centre for Health Protection (CHP) of the Department of Health today (October 19) drew the public's attention to the ongoing outbreak of plague in Madagascar, and urged travellers to observe heightened vigilance on rodents, anti-flea precautions and strict environmental hygiene.

     According to the World Health Organization (WHO), from August 1 to October 12, a total of 684 plague cases including 57 deaths were reported in Madagascar and 18 out of 22 regions were affected.

     Although plague has been endemic in Madagascar, unlike past endemic patterns, the outbreak this year arrived earlier than the usual surge from September to April. More cases of pneumonic plague, which can be transmitted from human to human, were recorded and, apart from endemic rural areas, urban cities were affected this year.

     "We are in close liaison with the WHO and health authorities of overseas and neighbouring areas to monitor the situation. We have been working with the Travel Industry Council of Hong Kong to keep travel agents, especially those operating long-haul tours, abreast of the disease for necessary precautions. Individual visitors should also stay alert to the ongoing outbreak," a spokesman for the CHP said.

     Travellers to Madagascar should heighten vigilance on rodents and prevent flea bites. Insect repellents against mosquitoes may equally prevent flea bites and blood-sucking insects. Formulations in lotions or sprays should contain DEET, IR3535 or icaridin (also known as picaridin) as active ingredients. The public should refer to the CHP's tips for using insect repellents.

     Locally, the CHP's Port Health Office conducts body temperature screening at boundary control points with thermal imaging systems on inbound travellers. Suspected cases will be assessed and referred to healthcare facilities for further management.

     "Travellers returning from affected areas with sudden onset of fever, shaking chills, body pains or chest discomfort should seek medical advice as soon as possible and reveal their travel history for prompt investigation and management. Plague is a statutorily notifiable disease and doctors should report suspected or confirmed cases to the CHP for investigations and control," the spokesman added.

     Hong Kong has been free from plague since 1929. The CHP remains vigilant in the prevention and control of plague through disease surveillance and public health education while the Food and Environmental Hygiene Department (FEHD) conducts rodent surveillance and control as well as the promotion of environmental hygiene.

     Plague is transmitted from an infected animal (mainly rodents) to humans through the bite of its fleas. Plague can also be contracted when cuts or other breaks in the skin come into contact with the body fluid or tissue of infected animals.

     Bubonic plague is not usually transmitted directly from person to person unless there is contact with pus from suppurating buboes. It can progress to septicaemic plague when the bacteria invade the blood stream. Pneumonic plague is highly contagious and can spread between humans by inhalation of respiratory droplets from an infected person. The case-fatality ratio of bubonic plague can be 30 to 60 per cent while pneumonic plague is always fatal if untreated.

     Travellers should take heed of the health advice below during travel:
  • Prevent flea bites by wearing long-sleeved shirts and trousers, and applying insect repellent/insecticide. DEET-containing insect repellent can be applied to exposed skin and clothing, while insecticide containing permethrin can be applied to clothing, not the skin;
  • Avoid going to rural areas, camping or hunting;
  • Never touch rodents, dead animals and their tissues or contaminated materials;
  • Avoid close contact with patients, especially those with cough or chest infection;
  • Avoid going to crowded areas;
  • Seek medical care immediately in case of sudden onset of fever, chills, painful lumps, shortness of breath with coughing and/or blood-tainted sputum; and
  • Consult a doctor immediately after contact or exposure to pneumonic plague patients or high-risk exposures, such as bites from fleas or direct contact with body fluids or tissues of potentially infected animals, for prompt assessment of the need for preventive medication.

     Travellers may visit the WHO's plague page, the CHP's plague page, Travel Health News and the FEHD's advice on rodent control for details.
Ends/Thursday, October 19, 2017
Issued at HKT 17:10
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