Location of Island of Madagascar
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We’ve news today of a relatively large outbreak of Bubonic Plague on the island of Madagascar (details below), that has resulted in as many as 20 deaths.
Bubonic Plague (Yersinia Pestis) is a bacterial infection transmitted by fleas, carried by infected rats. The infection generally sets up in the lymphatic system, resulting in the tell-tale buboes, or swollen lymph glands in the the groin, armpits, and neck.
Credit CDC
In rare cases Pneumonic Plague may develop. Here the infected person develops a severe pneumonia, with coughing and hemoptysis (expectoration of blood), and may spread the disease from human-to-human.
Since plague is fairly easily treated with antibiotics, it isn’t much of a public health menace in the developed world. In areas where treatment isn’t readily available, however, mortality rates run 40%-60% and untreated pneumonic plague is almost always fatal.
The last major urban outbreak of plague in the United States occurred in 1924-25 in Los Angeles. Since then, only scattered cases have been reported, with about 7-15 cases each year in the U.S..
According to the CDC: Between 1,000 and 2,000 cases each year are reported to the World Health Organization(WHO), though the true number is likely much higher. The last really big plague outbreak was in India nearly 20 years ago, as summarized by the WHO.
During August 26-October 5, 1994, a total of 5150 suspected pneumonic or bubonic plague cases and 53 deaths were reported from eight states of India, primarily in the south-central and southwestern regions.
Although reports of plague were initially denied by Indian officials, the mass exodus of hundreds of thousands of panicked people from Surat spread the disease to 7 Indian states. You can read Newsweek’s contemporaneous coverage of this event in The Plague of Panic.
Over the past year or so we’ve seen some limited outbreaks in Peru (see Alert For Bubonic Plague In Ascope Region and Kyrgyzstan (see A Fatal Case Of Bubonic Plague), but today we’ve news of an outbreak on the island of Madagascar that has reportedly claimed 20 lives. The following report comes from the Guardian.
Bubonic plague killed 20 villagers in Madagascar, health experts confirm
Announcement of one of worst outbreaks in years raises fears that disease could spread to towns and cities
Peter Beaumont theguardian.com, Wednesday 11 December 2013 08.18 EST
(EXCERPT)
The confirmation that bubonic plague was responsible for the deaths last week near the north-western town of Mandritsara follows a warning in October from the International Committee of the Red Cross (ICRC) that the island nation was at risk of a plague epidemic.
The Pasteur Institute of Madagascar revealed on Tuesday that tests taken from bodies in the village last week showed that they had died of the bubonic plague. The institute added it was concerned the disease could spread to towns and cities where living standards have declined since a coup in 2009.
Although there is no vaccine available, with the advent of effective antibiotics, large scale outbreaks of plague are increasingly rare. Still, the risk of infection is not zero, and so the CDC has some advice on how to avoid this illness by way of this 2-page PDF file.
I confess to having a particular interest in Plague, which stems from my working as a paramedic in Phoenix, Arizona where Bubonic plague cases are still occasionally found, and my reading – around the age of 11 – of James Leasor’s The Plague and The Fire which recounts two incredible years in London’s history (1665-1666) - which began with the Great plague, and ended with the Fire of London.
A highly recommended read (if you can find a copy) for both history and epidemic aficionados.
