By: Adam King
Impunity Rights News Reporter, Africa

WHO health worker tends to patient. Photo courtesy of Rijasolo/Agence France-Presse.

ANTANANARIVO, Madagascar  — The Pneumonic Plague, a disease considered by many to be nonexistent, continues to ravage large parts of Madagascar. As CNN reports, 124 people have died from the Plague so far with estimates of upwards of 1,200 people infected. The World Health Organization provides a thorough summary of the current outbreak.

“Since August 2017, Madagascar is experiencing a large outbreak of plague affecting major cities and other non-endemic areas. From 1 August through 30 October 2017, a total of 1801 confirmed, probable and suspected cases of plague, including 127 deaths, have been reported by the Ministry of Health of Madagascar to WHO. Of these, 1111 (62%) were clinically classified as pneumonic plague, including 257 (23%) confirmed, 374 (34%) probable and 480 (43%) suspected cases. In addition to the pneumonic cases, 261 (15%) cases of bubonic plague, one case of septicaemic plague and 428 cases (24%) where the type has not yet been specified, have been reported (Figure 1). As of 30 October, 51 of 114 districts of Madagascar have been affected (Figure 2 and 3). Since the beginning of the outbreak, 71 healthcare workers have had illness compatible with plague, none of whom have died.”

While 127 deaths seems to be low, a continued trend in the current direction could reach epidemic levels. The Centers for Disease Control and Prevention does not ascribe a  certain numerical figure to an epidemic, but rather where an agent and susceptible hosts are present in adequate numbers, and the agent can be effectively conveyed from a source to the susceptible hosts.” That appears to be how this strain of plague is being characterized.

“Pneumonic plague is more virulent or damaging and is an advanced form characterized by a severe lung infection that can be transmitted from person to person via airborne droplets such as through coughing or sneezing, for example. The incubation period is short, and an infected person may die within 12 to 24 hours.”

WHO does not believe that the infection will spread beyond Madagascar’s borders.

“WHO and the Malagasy government have stepped up screening at airports but say the infection is more likely to spread within Madagascar than it is to spread to other countries. But international spread is not a big threat, because pneumonic plague shows up quickly after someone is exposed to the bacteria. Exit screening at airports — like checking for fever — can help stop people from carrying the infection abroad.”

The difference between the widely known bubonic plague and the pneumonic version that is currently in Madagascar is the method of transference. Pneumonic is much more dangerous because it can be spread through contact between infected and uninfected people. Bubonic is transmitted from the bite an infected animal, which in the case of the plague in centuries ago in Europe, such as a rats or mosquitoes.

Despite these numbers, some opine that the outbreak is waning and new cases are on the decline.

“The large plague outbreak that began in Madagascar in August appears to be waning, according to government case counts and local news reports… A World Health Organization spokesman, Tarik Jasarevic, confirmed reports in Malagasy media that both deaths and new cases were declining and most hospitalized patients had recovered.”

For more information, please see:

NBC News — ‘Unusually Severe’ Plague Strikes 1,800 in Madagascar’ — 3 November 2017

The New York Times — ‘Deadly Plague Outbreak in Madagascar Appears to Wane’ — 2 November 2017

World Health Organization — Plague – Madagascar — 2 November 2017

BBC News — ‘124 dead, nearly 1,200 infected with plague in Madagascar’ — 25 October 2017

Centers for Disease Control and Prevention — ‘Principles of Epidemiology in Public Health Practice’ — 18 May 2012

Author: Impunity Watch Archive