Disease

Madagascar village 'hit by bubonic plague'

Tests were carried out after at least 20 people in the village, near the north-western town of Mandritsara, were reported to have died last week. The International Committee of the Red Cross warned in October that Madagascar was at risk of a plague epidemic. The disease is transmitted to humans via fleas, usually from rats.

Bubonic plague, known as the Black Death when it killed an estimated 25 million people in Europe during the Middle Ages, is now rare. Last year, Madagascar had 60 deaths from the plague, the world's highest recorded number. Health officials have now gone to the remote area to investigate.

Prisoners on the island are usually most affected by the plague, which is spread because of unhygienic conditions. The prevalence of rats in Madagascar's prisons means the plague can spread easily. There are concerns that the disease could spread to towns and cities where living standards have declined since a coup in 2009 and the ensuing political crisis.

Chikungunya in the French part of the Caribbean isle of Saint Martin

On 6 December 2013, WHO was notified of two laboratory confirmed cases of locally acquired chikungunya disease in the French part of the Caribbean isle of Saint Martin. The other part of the isle is a country that is part of the Kingdom of the Netherlands (Sint Maarten).

There has been an outbreak of dengue fever on St Martin / Sint Maarten since January 2013. Chikungunya disease was detected during an investigation following the notification of five cases with joint pains and fever on 18 November 2013, for whom the diagnosis of dengue was excluded. The onset of symptoms of the five cases occurred between 12 October and 15 November 2013.

As of 10 December 2013, altogether two confirmed, four probable and twenty suspected cases of chikungunya infection have been reported.

Chikungunya is a viral disease that is rarely fatal and is transmitted to humans by infected mosquitoes. Symptoms of chikungunya include high fever and headache, with significant pains in the joints (ankles, wrists), which can persist for several weeks.