An outbreak of pneumonic plague in Madagascar has infected 1,231 people and caused 124 deaths since the start of August. Nine countries and territories with trade and travel links to Madagascar, including tourist hotspots like Seychelles, Mauritius and the French territory La Réunion, have been advised to review their protocols for quarantining infected visitors. The World Health Organisation (WHO), which has been helping countries to prepare, told The Independent this was normal practice and “not directly

linked” to the risk of the disease spreading. Plague is endemic to parts of Madagascar with around 500 cases reported annually. But the current outbreak has reached densely populated cities and regions where it is not usually present, and are less prepared to handle cases. Pneumonic plague is a particularly infectious form because it invades the lungs and so can spread quickly from person to person, through coughing or in confined spaces. READ MORE