There is currently an outbreak of bubonic plague in widespread areas of Madagascar.

The Plague is a bacterial infection spread through bites by infected fleas. Plague causes high fever, swollen lymph glands and the infection can spread to the lungs

Plague pneumonia ( infection in the lungs) is the only way it that can be directly transmitted from one person to another. Plague can be treated with antibiotics. However, without prompt treatment, plague can cause serious illness or death.

No vaccine is available to prevent plague. But travelers can take steps to prevent plague, and complications of plague can be prevented with antibiotics.

Travelers to Madagascar should use insect repellent that lists protection against fleas on the label and contains at least 25% D.E.E.T. Avoid close contact with sick or dead animals. Avoid close contact with people who are coughing up blood.

Travelers who have had close contact with people with plague pneumonia should immediately contact a doctor. During or after travel to Madagascar, travelers should watch for symptoms of plague. If symptoms do appear, they should seek medical care and inform the provider about their travel to Madagascar. Antibiotics are available to treat the plague.