Plague outbreak in Madagascar kills 57 and rages on

By Dr. Ananya Mandal, MDOct 16 2017

The plague outbreak in Madagascar is killing scores of people and affecting hundreds. Last estimated on the 12th of October 2017, there are 57 reported deaths due to the disease with 680 down with the infection. Of these 25 deaths and 329 cases are from the capital city of Antananarivo.

The cases and deaths due to this infection are reported by the World Health Organization (WHO) and the National Bureau for Risk and Disaster Management (BNGRC) in Madagascar.

Madagascar faces plagues outbreaks almost yearly and there are hundreds of patients each year coming down with this infection. This year however has been different say experts. For one, this year the infections have begun earlier than every year making it a possibility that many more might be infected this year. Also the health officials report that this year the infections seemed to be occurring in the urban areas too unlike previous years.

The two of Madagascar’s largest cities, Antananarivo and Toamasina, are affected this year. Pneumonic plague that can easily be transmitted from one person to another is also on the rise this year, the reports suggest. Since 12th of October, the 684 cases include 474 cases of pneumonic plagues, 156 cases of bubonic plague and 1 case of septicemic plague. An additional 54 are not yet classified. At least 10 Madagascar cities from 35 out of the total 114 districts have been affected by plague say the reports.

As an effort to curb the outbreak the government is supplying antibiotics to protect and treat the cases of plague. Schools and all other public places are being sprayed with disinfectants that would control the fleas and the rats that could transmit the infection.

Public gatherings, schools etc. are closed at present to deal with the spread of the infection says the International Federation of the Red Cross (IFRC). Aids and help is being provided by numerous organizations including the UK Public Health Rapid Support Team, WHO, Medecins Sans Frontieres, the US Centers for Disease Control and Prevention (CDC), the Institute Pasteur etc.

The WHO, on the 6th of this month supplied 1.2 million doses of antibiotics and released emergency funds to the tune of $1.5 million to combat this infection. The Red Cross has contributed over a million dollars to start treatment centres and also to train health care workers to monitor and control the spread of the infection through awareness.

Plague

Plague is a bacterial infection also known as the Black Death as it wiped out a significant population of the world in the mid 1300’s killing 75 to 200 million Europeans and Asians. The infection is caused by a bacteria Yersinia pestis.

The bacteria spreads from animal to animal via fleas. The bite of an infected flea can carry the infection from one rat to another. Rats spread a type of plague called the bubonic plague that leads to formation of painful and swollen lymph nodes that are called bubos. In addition there is high fever. Another type of plague that is more dangerous is the pneumonic plague that leads to a severe life-threatening lung infection.

This form of infection spreads via aerosols that are released in the air as an infected person coughs or sneezes. This infection is very severe and within 12 to 24 hours of contracting the infection, an infected person may die. If detected early both bubonic and pneumonic plague can be effectively treated with antibiotics.

A rarer form of the infection is the septicemic plague. Here the infection spreads to the blood and affects all the tissues making them black and necrotic.

According to the WHO, plague is a disease of “poverty” caused mainly by the unsanitary living conditions. Pneumonic plague however can spread to not-so-poor individuals too because it is air-borne, the experts say. Madagascar has been fighting plague for a hundred years when steamships from India in 1898 brought in rats that were infected with this bacteria. In the 1930’s the disease was supressed to a great extent, only to reappear in the recent times for the last few decades.  The Democratic Republic of Congo and Peru too face regular serious outbreaks of plague.