Global Alert and Response (GAR)

2002 - Influenza in Madagascar - Update 4

23 August 2002

Disease Outbreak Reported

As of 22 August, the outbreak has extended to 5 out of 6 provinces in Madagascar, the exception being Antsiranana province in the north-east of the country. The total number of reported cases is 22 646 with 671 deaths. The most affected province is Fianarantsoa with 18 808 cases and 556 deaths.  The increase in numbers may be due, in part to a standard case definition established by the Ministry of Health now being applied to all districts.

The international team from the Global Outbreak Alert and Response Network is working with mobile teams from the Ministry of Health investigating these cases and collecting samples. To date, influenza A(H3N2) viruses have been isolated.      

Preliminary findings indicate that the high mortality rates may be attributable in part to the lack of access to health care and to very poor nutrition in the affected districts.  Along with the Ministry of Health, the WHO country office has been working with UNICEF and the World Food Programme to provide protein-enriched foods as soon as possible and to establish nutritional education centres.

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