As of 3 October 2017, a total of 194 cases (suspected, probable and confirmed) with 30 deaths (case fatality rate 15.5%) have been reported from 20 districts in 10 regions.
"In the framework of the fight against the spread of the plague, the universities of Toamasina and Antananarivo will be closed because of sanitation", says a note from the ministry of higher Education published on Thursday.
Madagascar has a history of plague outbreaks, which have occurred nearly every year since 1980, often sparked by rats fleeing forest fires.
Ten cities have reported outbreaks of pneumonic plague, while there have also been cases of bubonic and septicemic plague, the United Nations body said on its website. Saturday, the malagasy government has banned till further order the public gatherings in the capital to stop the epidemic of plague which has been raging for a month on the Big island. The outbreak has caused widespread panic, with long queues forming outside pharmacies to buy masks.
"WHO is concerned that plague could spread further because it is already present in several cities and this is the start of the epidemic season, which usually runs from September to April", Charlotte Ndiaye, a World Health Organization representative in Madagascar, said. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells lymph nodes and can be treated with antibiotics.
Pneumonic plague can kill quickly, within 18-24 hours of infection if left untreated, but it can be cured by early use of antibiotics. "We are lucky that treatment is available for this disease and it is free".