Oxford University conducts successful bubonic plague treatment in Madagascar

Researchers from the University of Oxford and Madagascar have conducted the world’s first rigorous clinical trial of treatments for bubonic plague.

As a result of the successful trial, researchers will be working with national and international bodies such as the World Health Organization (WHO).

They will look to provide the evidence that may be required to update clinical guidelines, which can translate the results into practice and save lives.

The trial proves that a ten-day course of an oral antibiotic is a highly effective and safe alternative to existing treatment with injectable antibiotic requiring hospitalisation.

The oral antibiotic course also costs only around 10% of the existing prescribed course of medical treatment.

Piero Olliaro, Professor at the Pandemic Science Institute, University of Oxford and senior author of the study said: “Despite its deadly history, we’ve had little clinical evidence on treating bubonic plague—until now.

“Thanks to the patients and healthcare workers in the trial, we now have real-world proof of effective, safe treatment. Ongoing data analysis will deepen our understanding of the disease, including risk factors, symptoms, and diagnostics.”

Despite cases of plague declining, it still remains a high-threat due to its widespread animal reservoir and potential for being weaponised via deliberate release.

Madagascar reports approximately 80% of global cases for life-threatening disease with a mortality rate between 15-25%.

However, the trail shown a mortality rate of 4% which much less.

The study was in collaboration with Madagascar’s health services and national plague programme, with the support of the Ministry of Public Health in the country.

Mihaja Raberahona, physician at CHU Joseph Raseta Befelatanana and researcher at the Centre d’Infectiologie Charles Mérieux Madagascar said: “In Madagascar, where plague cases occur in remote rural locations with limited healthcare infrastructure, taking a straightforward oral antibiotic is vastly preferable to a treatment requiring injections.

“It alleviates healthcare worker workload and is also much cheaper – costing about one-tenth of the current treatment regimen.”

Researchers designed the IMASOY trial to test two treatments for plague which were found to be highly effective and safe, with overall treatment success rates of about 90%.

Rindra Vatosoa Randremanana, Medical epidemiologist at Institut Pasteur de Madagascar said “The trial was a massive operational undertaking. Many patients were in remote villages and the unpredictable nature of the outbreaks made the research very challenging. Recruiting the 450 patients, of whom about half were confirmed with bubonic plague, took five plague transmission seasons and an army of research assistants, doctors and community health workers. We are hugely grateful to everyone who took part.” Hear all the latest news from across the UK on the hour, every hour, on Greatest Hits Radio on DAB, smartspeaker, at greatesthitsradio.co.uk, and on the Rayo app.