A report from the World Health Organization (WHO) from 6 November, 2017 has given insight as to the spread and severity of the plague in Madagascar. According to the report, there are 1,947 cases and 143 deaths. The Case Fatality Rate (CFR) is approximately 7%, which means that 7% of the patients that have contracted plague have died. 74% were “clinically classified as pulmonary plague” or pneumonic, 15% bubonic and only one was septicemic. These are not three random strains of plague, they generally start as bubonic and if they reach the lungs they become pneumonic, which can then be spread by coughing or other airborne means. 50 of these cases are believed to be aid workers.
Early diagnosis can provide quite positive results, but if left untreated the fatality rate can vary from 30% to 100%. Pneumonic plague is pretty much going to kill you if you don’t treat it. The unfortunate reality is that, in rural areas like places in Madagascar, fast treatment might not be so readily available–especially when the onset of plague actually just looks like the flu and not some huge emergency.
WHO expects this outbreak to continue to grow in severity until plague season ends around April of next year. If you’re wondering whether or not I said that right, yes–plague season is a thing. It is not uncommon in Madagascar and though this outbreak is the worst they’ve had in a long time, it certainly isn’t the first time.
Several rumors have been circulating that the plague is stemming from an old tradition: a practice called “famadihana” that involves digging up the body of a buried loved one, wrapping the corpse in fresh cloth and dancing with the remains–a sacred ritual among some people in Madagascar. While it is inaccurate to say that plague originates from this practice, the dancing could very well be contributing to the rapid spread of pneumonic plague. If that loved one died because of the disease, direct contact could infect those involving themselves in famadihana. The actual disease originates from a bacteria carried by the oriental rat flea.