The bubonic plague, also known as the black plague, has returned stopping in Africa. An outbreak of the plague in Madagascar has already claimed the lives of over 40 people. The UN World Health Organization (WHO) has sent out warning of rapid spread of the bacterial disease in the capital of Antananarivo.
The bubonic plague is a zoonotic disease that is carried mainly in fleas and small rodents. The plague is one of three types of infections brought on by Yersinia pestis, an enterobacteriaceae family member. It kills two thirds of infected humans within four days of infection. It is believed to be the cause of the Black Death which swept through Europe in the 14th century. In the Mediterranean, the disease flourishes in the summer while in northern Europe, autumn was the time of the most frequent outbreaks.
The black plague, most often carried by rats, has returned, stopping in Africa and taking the lives of 47 people in Madagascar. Numbers are expected to increase to at least 138 according to Secretary General of the Health Ministry Philemon Tafangy. The first case of the disease was reported back on Aug. 31. A villager from Soamahatamana contracted the illness and died a few days later on Sept. 3.
Tafangy reported the outbreak to the WHO on Nov 4. Since the initial report, cases have been reported in 16 Madagascan territories. Two percent of the reported cases were for the pneumonic form of the black plague. Two cases, one of which included a death, were reported in the capital of Antananarivo. WHO released a press release stating the risk of rapid spread due to high population density and weakness of the healthcare system in the capital. The WHO stated they are coordinating with partners, including the Red Cross, the Pasteur Institute of Madagascar, and the Commune urbaine d’ Antananarivo, alongside the Madagascan government to contain the outbreak.
According to the health ministry, 200 homes have been disinfected in November. Those that had contracted the illness are being treated and individuals in contact with the infected have been given antibiotics for preventive measure.
The housing situation in the capital is cumbersome with residents living in squalid conditions. Residents of Ankasina, a slum village outside the capital, say their area is infested with rats. Bernadette Rasoarimanano lost a daughter to the plague and claimed that the neighborhood had been neglected by the state for so long it fell into filth and despair. Members of the community has given her and her family “dirty looks” since the death of her daughter as the stigma surrounding the death grows.
Protective measures have been implemented including the use of spray materials, insecticides, protective equipment and antibiotics. Containment is complicated by high levels of resistance to deltamethrin observed in the flea population. The bacterial disease is spread from one rodent to another via fleas. When a human is bitten by an infected flea, chances are likely that the black plague will develop starting with a swelling of the lymph node. From that point the black plague can develop into pneumonic plague which is increasingly fatal. The pneumonic form of the plague affects the lungs and is spread from person to person through coughing. Patients that contract the pneumonic form can die within 24 hours of infection.
As reported by the Daily Mail, outbreaks occur often in the region and usually it is at its worst between October and March. The last severe outbreak in the capital happened 10 years ago according to Christophe Rogier of the island’s Institut Pasteur. Per the International Committee of the Red Cross, 500 cases of plague are reported every year in the region since 2009.
Health experts issued a warning last year in region that risk of outbreak was imminent unless the spread of the disease could be slowed. Inmates in the rat infested prisons were deemed to be most at risk reported the BBC.
From 2004 to 2013 more than 13,000 cases of the plague were reported, 896 of them being fatal. Africa had the highest number of cases with 97.6 percent according to WHO. In the middle ages, the black plague, or Black Death, claimed the lives of 125 million people in Europe. While Ebola has remained a cause for concern as of late, the return of the black plague adds additional health concerns as it stops in Africa.
By Stevenson Benoit
Photo by Wiblick – Flickr License