European Immunization Week

Madagascar, with its many thousands of kilometres of picturesque coastline, is often considered an idyllic holiday destination. Perfect for relaxing and basking in the beauty of your surroundings, it boasts vast coral reefs brimming with life and acting as the home for a range of weird, wonderful and rare plant and animal life.

But Madacascar has made the news for another reason in recent months. Last week the World Health Organization (WHO) confirmed that Madacascar has seen a dangerous outbreak of the bubonic plague over the last year. With an estimated 60 fatalities last year, the situation is now considered endemic on the small island.


What is the bubonic plague?

The bubonic plague, otherwise known as the infamous Black Death, is best known as a disease of the 17th century. But it is actually a disease that has been consistently contracted across regions of Africa over the last century. In countries such as the Democratic Republic of the Congo, Madagascar and Tanzania, outbreaks of the disease occur seasonally and relatively frequently.

The bubonic plague is a disease transmitted to humans through animals which harbour infected fleas, most commonly rats. The infection causes a swelling of the lymph nodes and can be easily treated with antibiotics if it is caught early.

In response to the deaths in Madagascar, the Red Cross are currently enacting a pest control scheme across the island in order to tackle the outbreak. However, once contracted by humans and spread to the lungs, the disease becomes significantly more infectious from human to human. If the bacteria reaches the lungs, the patient then develops a pneumonic form of the plague which can then be spread from human to human via infected droplets when coughing.

According to WHO director-general Margaret Chan, around 8% of cases across Madagascar have progressed to this stage, causing a risk of more widespread infection occurring across the island.

However, according to Christophe Vogt, a member of the International Committee of the Red Cross based in Madagascar, it is not the disease itself which poses the biggest problem for the island:

“The biggest killer in this country, and in many places of the world, is really ignorance. Because with the plague, as long as you have access to medicine, to a diagnosis, information, to prevention techniques such as keeping your place clean of rats, there are many measures that can be taken.”


Taking precautions against diseases on holiday

With 8,000 UK residents visiting Madagascar every year, the recent outbreak serves to highlight the kind of unforeseen danger that can halt travel plans – or worse, lead holidaymakers to visit a country unaware of the potential threats that await them.

If you are booking a holiday abroad it is always important to not only ensure that you are up to date on all relevant travel immunisations but also stay informed as to the latest developments in the weeks and months leading up to your holiday.

Here are some of the most credible websites which offer travellers vital information regarding health risks around the globe based profiles of individual countries: is a great source of information with health, political and social updates on countries around the globe.

–       National Travel Health Network and Centre ( offers recent clinical updates, general health risks, and outbreak surveillance for individual countries around the world.

–       Fit for Travel ( and the Centre for Disease Control ( both provide country profiles which outline the at-risk diseases in each country and which vaccinations are recommended before travel to these countries.

You can also seek assistance from your travel clinician. It is a clinicians job to stay up to date on developments around the world and advise on not only the immunisations but also the relevant precautions holidaymakers should take in relation to their travel plans.