Madagascar

WHO Director-General: invest in health to end plague in Madagascar

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The Director-General of WHO has outlined his vision for a Madagascar free of plague epidemics during a three-day visit to the island nation that started on 7 January 2018.

“Madagascar can make plague epidemics a thing of the past through strategic investments in its health system – including better access to healthcare, improving preparedness, surveillance and response capabilities, and implementing the International Health Regulations,” said Dr Tedros Adhanom Ghebreyesus.

During his first visit to Madagascar since his election as Director-General of WHO last year, Dr Tedros is due to meet with plague survivors and affected families, key Ministers and officials leading response efforts, the President and First Lady, and representatives of UN agencies and health partners. He will also visit a plague treatment centre, and the National Operational and Strategic Centre for Epidemiological Surveillance.

On the first day of the visit, the WHO Director-General thanked national authorities for their leadership and partners for their support during the recent nationwide outbreak of pneumonic and bubonic plague that caused more than 200 deaths over four months.

“This unprecedented pneumonic plague outbreak was contained due to the tireless efforts of Malagasy health workers and partners. WHO will continue to support plague preparedness, control and response, and we call on our international development partners to help us end human outbreaks. This will include better understanding of the wider factors that allow plague to spread, and strengthening national capacities to manage similar emergencies in the future,” said Dr Tedros.

Although the acute phase of the epidemic was declared over by health authorities in late November 2017, plague occurs seasonally in Madagascar, usually between September and April each year.

Dr Tedros was accompanied by WHO Regional Director for Africa Dr Matshidiso Moeti who cautioned that the response must be sustained until the end of the plague season and beyond.

“We must sustain a strong alert and response system to rapidly detect and respond to new plague cases as they emerge,” said Dr Moeti. “WHO urgently requires an additional US$ 4 million to sustain response operations over the next three months and until April 2018.”

When the outbreak was detected in August 2017, WHO rapidly mobilised financial, operational and technical support to Madagascar and neighbouring countries – releasing emergency funds, delivering medicines and supplies, sharing guidelines on case management and safe burials, supporting surveillance and laboratory testing, and strengthening public health measures at ports and airports. More than 4400 people were trained to identify, refer and care for close contacts of plague patients to prevent the disease from spreading.

“With support from WHO and other partners we provided treatment to nearly all identified plague patients and more than 7300 contacts free of charge,” said Dr Lalatiana Andriamanarivo, Minister of Health of Madagascar.

Through its Health Emergencies programme, financial support for WHO’s response to the plague outbreak in Madagascar has been provided by the WHO Contingency Fund for Emergencies (CFE) and the governments of Italy, Norway and the Republic of Korea. WHO and the Global Outbreak Alert and Response Network (GOARN) staff deployed more than 135 staff to Madagascar to respond to the outbreak.

Research group suggests Madagascar’s unique animals arrived on rafts.

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Ever since the island of  was first visited by people, some two thousand years ago, there has been speculation about the unique plants and animals that live on the world’s fourth largest island; one where roughly ninety percent of the wildlife is found nowhere else. For many years, it was believed they came to be there during the time when the island was still physically connected to Africa, but that reasoning has fallen by the wayside as it has been shown that the island separated some 88 million years ago, while most of the animals that live there didn’t arrive till just 60 million years ago, forcing evolutionary scientists to search for other explanations. Now new evidence by an international group of researchers is proposing that the animals got there by floating on rafts during a time when prevailing currents would have made the journey more plausible. They have published a paper on their ideas in the Proceedings of the National Academy of Sciences.

 

Today, the distance between Madagascar and Africa is about 250 miles (400 kilometers), far enough to make the journey by raft virtually impossible due to a lack of fresh water to drink, not to mention overheating and sunburn. But, say the researchers, some 60 million years ago, things were different. During that time, the island was in a slightly different position. In particular, its northernmost edge hadn’t started creeping into the southern equatorial current, which means ocean currents would have been able to flow from west to east, which would have helped tremendously. If the animals were to ride over, they would have done so accidentally due to finding themselves marooned on a raft made of natural vegetation torn from the ground during a cyclone, examples of which have been seen often enough in modern times to prove that it can happen. If such a situation did occur, it’s possible the small raft could have been blown far out to sea by a storm that also deposited enough water on the raft to allow any animals aboard to survive the trip from Africa, or even Asia.

The researchers came to these conclusions after building a database of all the animals on the island and then working backwards using genetic evidence to pinpoint almost precisely the time frame that they diverged from their African cousins. Once they had that, they studied research findings regarding conditions on the Earth in that area and found that it was likely that the ocean currents could have been flowing east to west due to tectonic shifting.

The research team suggests that the animals would also have had time on their side. Over a span of millions of years, a rare event such as animals floating over could have occurred often enough to account for the animals that did make it over and who eventually began reproducing.

The team also points out that once the island shifted enough to change ocean currents, the numbers of animals reaching Madagascar diminished greatly, which explains why those that did make the trip lived in almost complete isolation, giving rise to the evolution of such exotic species.

Abstract 
How, when, and from where Madagascar’s vertebrates arrived on the island is poorly known, and a comprehensive explanation for the distribution of its organisms has yet to emerge. We begin to break that impasse by analyzing vertebrate arrival patterns implied by currently existing taxa. For each of 81 clades, we compiled arrival date, source, and ancestor type (obligate freshwater, terrestrial, facultative swimmer, or volant). We analyzed changes in arrival rates, with and without adjusting for clade extinction. Probability of successful transoceanic dispersal is negatively correlated with distance traveled and influenced by ocean currents and ancestor type. Obligate rafters show a decrease in probability of successful transoceanic dispersal from the Paleocene onward, reaching the lowest levels after the mid-Miocene. This finding is consistent with a paleoceanographic model [Ali JR, Huber M (2010)Nature 463:653–656] that predicts Early Cenozoic surface currents periodically conducive to rafting or swimming from Africa, followed by a reconfiguration to present-day flow 15–20 million years ago that significantly diminished the ability for transoceanic dispersal to Madagascar from the adjacent mainland.

Source: PhysOrg.com