Plague in Madagascar

This article appears on page 14 of the December 2017 issue.

The World Health Organization declared an outbreak of plague in Madagascar on Oct. 1. As of Nov. 1, at least 124 people had died and more than 1,200 people had contracted the disease since the first case was reported in late August. 

One person was diagnosed with plague in Seychelles after traveling to Madagascar. In response, Seychelles restricted travel to and from Madagascar, as have the East African nations of Comoros, Ethiopia, Kenya, Mauritius, Mozambique, RĂ©union (France), South Africa and Tanzania.

Plague was introduced to Madagascar in the 19th century and is now endemic, infecting an average of 400 people per year in that country. It is most often spread from the bites of fleas but also can be spread by contact with infected people. 

All forms of plague are caused by a single species of bacterium. Symptoms typically begin as flu-like before progressing to advanced stages. The most common form of plague is bubonic, which causes swollen lymph nodes known as buboes. If left untreated, bubonic plague can become septicaemic plague (causing blood poisoning) or pneumonic plague (causing a lung infection), both very deadly. (Rarely, the septicaemic and pneumonic stages can occur without a bubonic stage.) 

Plague is easily treated with antibiotics if caught early.