Red Cross volunteers talk to villagers about the plague outbreak – (AP Photo/Alexander Joe)

Madagascar: public activity has slowed to a stop.  Public events and meetings have been banned, school is out and the only busy areas are the lines stretching out behind health facilities and clinics as people wait for antibiotics.  The Red Cross, reporting a “doubling of cases over the last week”, has been developing and is deploying its first treatment center in an effort to support aid organizations in the area.  The World Health Organization (WHO) has “delivered nearly 1.2 million doses of antibiotics and released US 1.5 million dollars in emergency funds to fight plague in Madagascar.”  They also have to ensure “safe burials” for those who are now deceased, but still potentially infectious.

Time is of the essence.  Dr. Charlotte Ndiaye, WHO representative in Madagascar, said that, “Plague is curable if detected in time.  Our teams are working to ensure that everyone at risk has access to protection and treatment.  The faster we move, the more lives we save.”  Plague is one of the three diseases specifically reportable to WHO, the others being yellow fever and cholera.

“The Black Death” – image courtesy of Wikimedia Commons

It is important to realize the distinction between the popular definition of the word “plague” and the scientific one.  People generally think that a plague is a pandemic or widespread disease of any kind–we think of the smallpox that tore through the Native Americans or the latest Ebola outbreak.  There is actually a specific medical definition of “plague”–it’s an infectious disease caused by Yersinia pestis, a bacterium typically originating from the oriental rat flea.  This is what forms plague, which comes in three categories: pneumonic, septicemic and bubonic.  Bubonic plague was the cause of The Black Death that killed a third of the human population on earth in the 14th century.

A patient gets infected with bubonic plague, and if it goes untreated it hits the lungs and can turn into pneumonic plague, which is the case in Madagascar.  Because it’s in the lungs, it can spread easily as people literally cough the plague onto others, infecting them quickly.  They soon develop a fever, headache, chest pain, a cough and begin breathing rapidly.  Patients can die within 36 hours if it goes untreated.

WHO reports that between 2010 and 2015, 3248 people were infected with plague around the world, and that 584 of them had died.  This is not the first time plague has been reported in Madagascar, and approximately 400 cases occur each year.  Other countries prone to plague outbreaks are the Democratic Republic of Congo and Peru.

The country’s public health commissioner, Dr. Jude Gedeon, made sure to reiterate: “The situation in still not under control in Madagascar.”

Image courtesy of WHO

Featured image courtesy of AP Images.