Case definition for any case of plague, since 1 August 2017 and related to the outbreak of plague in Madagascar

Bubonic plague:

• Fever AND sudden onset of painful lymphadenitis

OR

Pneumonic plague:

• Fever

AND at least one of the following three:

• Cough
• Chest pain
• Haemoptysis

OR

Septicaemic plague:

Laboratory criteria for a probable case

• Detection of Yersinia pestis F1 antigen in a clinical specimen
• Detection of Yersinia pestis anti-F1 antigen specific antibody in one blood specimen

Laboratory criteria for a confirmed case

• Isolation of Yersinia pestis from a clinical specimen
• Detection of Yersinia pestis nucleic acid from a clinical specimen

Returning from Madagascar or contact with a traveller returning from Madagascar in the past 7 days

OR

In the past 7 days, at least one of the following:

• Close contact with a confirmed or probable case
• Close contact with rodents in Madagascar
• Flea bite in Madagascar