PT  - JOURNAL ARTICLE
AU  - Van Kinh Nguyen
AU  - Cesar Parra-Rojas
AU  - Esteban A. Hernandez-Vargas
TI  - The 2017 plague outbreak in Madagascar: data descriptions and epidemic modelling
AID  - 10.1101/247569
DP  - 2018 Jan 01
TA  - bioRxiv
PG  - 247569
4099  - http://biorxiv.org/content/early/2018/01/14/247569.short
4100  - http://biorxiv.org/content/early/2018/01/14/247569.full
AB  - Since August 1, 2017, Madagascar has endured an outbreak of plague. A total of 2119 cases of plague has been confirmed, causing until now a death toll of 195. Public health interventions have been introduced, preventing new cases and deaths. However, it is likely that the outbreak could reappear as plague is endemic in the region and typically only last until April annually. We collected real-time data from various official reports. We described the outbreak’s characteristics and reported estimates of the key transmission parameters using statistical and mathematical modelling approaches. Plague’s epidemic curve depicts a propagated outbreak with multiple peaks, caused by continuing exposure. Plague’s reproduction number is at least 1.22, with the effective estimate reaches 6.67. Optimal climate conditions for rat flea to flourish were observed during the epidemic. The main mode of transmission is human-human with a high transmission rate compared to flea-human. With a potential of continuing exposure to infected rat fleas until April 2018, current public health efforts should be maintained at the same level. While efforts in controlling vector to prevent the appearance of new index cases can be critical, maintaining interventions targeting reduce human-human transmission is key to prevent large-scale outbreaks.