Virus spreads to five provinces

More than 670 people have died and 22,000 have been affected by a severe strain of the flu in Madagascar. The World Health Organisation (WHO) said on Wednesday that only the province of Antsiranana, in the northeast, had so far been unaffected. The epidemic, which was first reported in June, has spread to five provinces. It has been particularly virulent in the poorest province, Fianarantsoa, where 556 people have died from the virus. But officials denied the epidemic was out of control, saying that the increase in the number of reported deaths in recent days was due to improved monitoring of the situation by health officials. Two weeks ago the death toll stood at 374. "The explanation could be improved surveillance between the ministry and WHO," the WHO Resident Representative Andre Ndiguyeze said. He added that the high number of deaths could be due to record levels of malnutrition and poverty, following the country's recent political upheavals. Thousands of jobs were lost and the economy was brought to its knees following disputed presidential elections in December last year. An additional humanitarian crisis was caused by a tropical storm which flooded large areas in the east of the country, leaving hundreds of people homeless. The virus, identified as influenza A, causes severe headaches, followed by neck and chest pains, Ndiguyeze said. "Although influenza A is definitely the prevalent virus, since the start of August, additional influenza A strains have been isolated from cases in different provinces. "The WHO and other UN agencies are in the process of shipping protein-enriched food to remote areas. Very few people who have had access to treatment have died, and those who have died, did so from complications. Our investigations, however, are ongoing. We are isolating specific cases and are collecting samples," Ndiguyeze said. According to World Bank figures, Madagascar is the eighth poorest country in the world.