Airborne Pneumonic Plague Spreading in Madagascar

bubonic plague returns to madagascar black death bubonic and pneumonic
Danse Macabre

Great. Just great. Bubonic and pneumonic plague are spreading.

From The Daily Mail:

The El Niño which caused havoc to the world’s weather in 2016 may be responsible for the severity of this year’s deadly plague outbreak in Madagascar.

Experts believe the natural phenomenon dubbed ‘Godzilla’ triggered an increase in rat populations in rural areas, sparking the beginning of the epidemic which has so far infected at least 1,300 people.

Forest fires have also driven the rats and their plague-carrying fleas towards areas inhabited by humans, local reports state as a reason behind the surge in cases recorded this year.

But Professor Matthew Bayliss, from Liverpool University’s Institute of Infection and Global Health, suggested floods and heavy rains – triggered by Cyclone Enawo, may also be to blame.

Concerned officials have also warned an ancient ritual, called Famadihana, where relatives dig up the corpses of their loved ones, may also be fueling the spread. Some 600 cases of plague are reported each year in Madagascar, but because this year’s outbreak has struck early, some are worried it will continue to pick up speed.

Two thirds of the cases are suspected to be pneumonic plague – described as the ‘deadliest and most rapid form of plague’. It is spread through coughing, sneezing or spitting and can kill within 24 hours. It has been reported that 50 aid workers are among those infected.

If bubonic plague – which is transmitted by flea bites – is left untreated, it can turn into pneumonic. So far 93 official deaths have been recorded, but UN estimates the toll may be as high as 124, which has prompted warnings in nine nearby countries – South Africa, Seychelles, La Reunion, Mozambique, Tanzania, Kenya, Ethiopia, Comoros and Mauritiu

From the CDC Madagascar Plague update:

What is plague?

Plague is a bacterial infection that is usually spread through bites by infected fleas. When acquired by flea bite, plague causes symptoms of high fever and swollen and tender lymph nodes (bubonic plague) that usually occur 2–6 days after the bite. If it is not treated, the infection can spread to the lungs and cause pneumonia.

Plague pneumonia (or “pneumonic plague”) is the only form that can be directly transmitted from one person to another. In rare but serious cases, a person with severe plague pneumonia can spread the infection directly to others by coughing up droplets that contain the plague bacteria. These bacteria-containing droplets can cause pneumonic plague in another person if breathed in (more information). Symptoms of plague pneumonia typically appear 2–4 days after inhaling plague bacteria and usually include sudden onset of high fever and cough and other general symptoms such as headache, chills, and weakness.

Plague can be treated with antibiotics. However, without prompt treatment, plague can cause serious illness or death.

How can travelers protect themselves?

No vaccine is available to prevent plague. But travelers can take steps to prevent plague, and plague can be prevented with antibiotics. Travelers to Madagascar should

  • Use EPA-registered insect repellent that lists protection against fleas on the label and contains at least 25% DEET.
  • Avoid close contact with sick or dead animals.
  • Avoid close contact with seriously ill people, especially people who are coughing up blood.

Travelers who have had close contact with people with plague pneumonia should immediately notify a health care provider. They may need to take antibiotics to prevent plague.

During or after travel to Madagascar, travelers should be alert for symptoms of plague. If symptoms do appear, they should seek medical care and inform the provider about their travel to Madagascar.

Learn more about plague, how to prevent it, and what to do if you think you are infected at CDC’s plague page for travelers.





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