Pneumonic Plague that killed 50 Million is Back

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Very little sounds more unsettling than the risk of catching “the plague” but most of us think this is just something that was around during the Middle Ages because of poor hygiene.

Unfortunately, that’s incorrect, and to prove it, there is an epidemic of the pneumonic plague in Madagascar right now. We all remember reading about The Black Death during history lessons in school. It was a horrific pandemic that nearly wiped out Europe, killing a disputed number of people that ranges between 50 million and 100 million.

Also known as the pneumonic plague, here is a quick video to get you up to speed on your medieval history. It’s bad and it’s reminiscent of the Liberian Ebola outbreak in 2013, that alarmingly made its way to American soil.

The New York Times reported on the situation in Madagascar: Since August, the country has reported over 200 infections and 33 deaths.

The outbreak is beginning to resemble the early stages of the West African Ebola crisis in 2014: a lethal disease normally confined to sparsely populated rural areas has reached crowded cities and is spreading in a highly transmissible form.

Schools, universities and other public buildings have closed so they can be sprayed to kill fleas, which may carry the infection. The government has forbidden large public gatherings, including sporting events and concerts. Fears that the outbreak could spread to other countries are rising.

Late last month, plague struck a basketball tournament for teams from Indian Ocean countries, killing a coach from the Seychelles and infecting another from South Africa. The players are being monitored, Malagasy health authorities told the W.H.O. Madagascar typically has about 400 cases of plague each year between September and April, but they are usually focused in the nation’s central highlands and spread by fleas living on rats in rice-growing areas.

This outbreak is unusually worrying because most new cases are in cities and are pneumonic plague, the form transmitted by coughing. (source) Madagascar is a large island of 224,533 square miles off the coast of southeastern Africa. It has a population of more than 25 million people in an area that is approximately twice the size of the state of Arizona. In comparison, Arizona has just over 6 million people, so as you can see, Madagascar is densely populated.

The biggest city on the island is Antananarivo, which has a population of 1,391,433, and concerningly, Patient Zero of the current outbreak traveled through the city by public transit, causing great concern of the possible ramifications.

The Madagascar outbreak started in August, when a 31-year-old man originally thought to have malaria traveled by bush taxi from the central highlands to his home in the coastal city of Toamasina, passing through the capital, Antananarivo. He died en route and “a large cluster of infections” broke out among his contacts, according to a W.H.O. update issued Oct. 4.

Those contacts passed it on to others. Plague was not confirmed until blood samples collected from a 47-year-old woman who died on Sept. 11 in an Antananarivo hospital of what appeared to be pneumonia were tested at Madagascar’s branch of the Pasteur Institute. The samples came up positive on a rapid test for plague. (source) Hasn’t Madagascar dealt with the plague before?

Madagascar is no stranger to the plague, with about 400 cases every year, but this time around, it’s the pneumonic plague, which is far more contagious and deadly. …the majority of cases are of pneumonic plague, which affects the lungs and is transmitted through coughing. It is considered to be the most deadly form of the disease and can be fatal within 24 hours.

The less deadly bubonic plague is often spread by rodents fleeing forest fires. Humans usually become ill after being bitten by infected fleas. Public gatherings have been banned in response to the latest outbreak.

A specialised hospital in the capital Antananarivo is struggling to cope with the influx of ill people, local media reported, with long queues outside for face masks and medicine.

This year urban areas have been affected, a development that has worried aid agencies in a country not renowned for a robust healthcare system. (source) Of course, with urban areas comes public transportation, and even more alarmingly for the rest of the world, an international airport.

There has already been at least one documented case of pneumonic plague leaving the island, causing Air Seychelles to halt service to Madagascar: “Following the advice and request of the Public Health Authority of Seychelles concerning the plague epidemic in Madagascar, Air Seychelles will temporarily suspend its services between Seychelles and Madagascar from Sunday 8 October 2017.”

This is the content of the official communiqué of Air Seychelles which will no longer serve Madagascar from tomorrow 08 October 2017. It is certain that the Seychelles authorities did not appreciate the death of the Seychellois basketball coach in Madagascar following a pulmonary plague he contracted on the spot during the basketball tournament in Antananarivo.

It was only after this unfortunate death that the Malagasy authorities took action and began a thorough awareness campaign. (source) Aside from this, I could find no other travel restrictions to or from Madagascar. What is the plague?

There are three types of plague: bubonic plague, septicemic plague, and pneumonic plague. Bubonic plague is spread via infected fleas and small animals.

It can result from bites or exposure to the body fluids of dead, plague-infected animals. It can enter through the skin by a flea […]

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