Click here to read about what plague actually is, and why it’s a specific infectious disease and not just any old pandemic.

Madagascar is no stranger to plague, but this year’s outbreak has long since left the norm. It has been more focused around higher population centers, allowing the infectious disease to spread quicker than the usual, rural places it tends to pop up in. It is now able to be transmitted by coughing or sneezing, no longer requiring the rat flea to directly transmit it to each person. 61% of the plague can now spread this way (pneumonic), and over 127 people have died so far. “More than 1800 suspected, probable or confirmed plague cases were reported,” according to the World Health Organization (WHO).

WHO has been looking into the possibility of plague spreading off the island countries and into nearby nations. “Neighbouring Comoros, Mauritius, Mozambique, Reunion and Mayotte, Seychelles, South Africa, and the United Republic of Tanzania were prioritized for increased plague preparedness and surveillance. WHO has also helped Ethiopia and Kenya to raise preparedness levels because of their direct airline connections with Madagascar.”

WHO has also been supporting Madagascar in mitigating the risks of plague spreading via travelers inside and outside of the infected country. Authorities in Madagascar have been screening passengers as they leave, ensuring no one flies or sails out with plague in their lungs or the fleas on their person. With that said, not every form of travel can be tightly controlled, especially since they are dealing with the outbreak itself, let alone any under-the-table travel that might slip through the cracks.