DW: Madagascar has suffered plaque outbreaks almost every year since 1980. How serious is this year's outbreak that has left over 20 dead and over 100 infected?

Charlotte Ndiaye: The [bubonic] plague is an endemic disease in Madagascar, but this year we've had a pneumonic plague [a form of plague that can spread human-to-human via droplets]. It has been detected in several cities in Madagascar since August 17.

It is an urban outbreak - we have the pneumonic plague in the capital Antananarivo and different big cities in Madagascar. 

It's highly transmissible - person-to-person - and quickly causes death without treatment.

How is the World Health Organization (WHO) responding to this outbreak?

We are doing everything we can to support the government's efforts. At the moment, we have deployed WHO staff in all different cities. And we have mobilized funds and we are working to provide surveillance, equipment and drugs to the country. We are coordinating all partners in order to deploy our efforts in all different cities.

Why are there recurrent outbreaks in Madagascar?

As you may know, every year between September and April, unfortunately we've had cases of plague in Madagascar. The common form we usually had is bubonic plague, but this year due to the lack of action we have pneumonic plague among people who are living in cities.

Why in the cities? Is there a reason behind it?

The first case was because someone left the village and traveled to the city. And during the travel, he was sick and he contaminated people on the bus, people in different hospitals.

Many people don't actually know about the plague, they just know it comes from rats. What are the key things people need to know to prevent it and stop its spread?

The first thing is to take urgent measure. The second thing is to be well-informed, so it means when people have symptoms of fever, buboes [inflammatory swelling of a lymph gland] or other symptoms, they have to quickly go to a health center. And at the health center we are able to do rapid diagnostic tests and also to give them antibiotic drugs.

What is important to know is that the plague can be treated. We have to diagnose the disease early.

Is there any link between poor living areas and plague?

Absolutely, as you may know, people in Madagascar are really poor and people have a problem of hygiene. That's why most of the time, cases of plague are coming from villages. But the problem we have today is the movement from people in villages to cities so that is why we have this urban plague this year.

How can Madagascar prevent such recurrences in the future, because it happens every year and many people are losing their lives?

The first thing for WHO and for all partners is to bring awareness to the government, to put the problem of the plague as a priority. And also to put emphasis on surveillance which is key when it comes to plague and other epidemics. WHO has worked very closely with the ministry of health, in order to put in place electronic surveillance, in all the 22 regions of the country so that we are informed early and know how to take care of people who have been diagnosed with plague.

Charlotte Ndiaye is the WHO country representative in Madagascar.