The Plague Hits Madagascar

A Professor's Perspective on Current Events

Image of Professor Barry Fox, M.D.
By Professor Barry Fox, M.D.

Professor Barry Fox and Linda Fox, EdM, comment on the recent outbreak of the pneumonic plague in Madagascar.

Madagascar, the 4th largest island in the world, is home to 22 million people.  It is known for its beautiful beaches, is home to over 15,000 species of flora and hundreds of species of exotic birds and reptiles. Unfortunately, this paradise also has something else that’s unique to the island:  annual plague outbreaks!

Plague is an infectious disease caused by a bacteria which is found in small mammals and fleas. Humans can be infected through the bite of an infected flea, contact with infectious bodily fluids or by inhaling small droplets from a patient who has pneumonic plague through sneezing and coughing.

Most people think of the plague in terms of The Black Death – an epidemic of enormous proportions that occurred in the 1300s, killing more than 20 million people in 5 years! However Plague continues to circulate today in the U.S., South America, and Asia, but most cases today occur in Africa.

The current outbreak of Plague is especially concerning for two reasons:  1) it is occurring in widespread areas of the island, but also in heavily populated cities.  Almost all of the cases in the last 20 years have occurred in villages and rural areas.  2) about 75% of the cases are in the pneumonic form, which is the most deadly. Previously most annual cases were in the less-deadly bubonic form. Pneumonic plague has a high fatality rate if not quickly treated with antibiotics, (within 24 hours of onset of symptoms) and can also spread rapidly from human to human.

Relatives dancing with the corpses of their loved ones are helping to spread the plague, officials have warned. (IMAGE: AFP OR LICENSORS)

There are substantial implications for tourism and travel with the current outbreak in that in its pneumonic form, it is quite contagious, and travel to crowded cities, airports, and seaports can pose health risks.  Plague warnings have also been issued for 9 countries surrounding Madagascar (Kenya, Ethiopia, South Africa, Mozambique, Tanzania, Reunion, Mauritius, Seychelles, Comoros).  Since a cough can spread the infection up to about 6’, close contact in crowds, or on various means of transportation can exponentially increase the number of cases.

This article is part of our Professor’s Perspective series—a place for experts to share their views and opinions on current events.

What if you have travel plans to one of these areas? Travelers should use insect repellent to avoid flea bites, avoid sick or dead animals, and avoid contact with sick people, especially ones who are coughing or sneezing.  If you have symptoms of fever, headache, chest pain or shortness of breath after traveling to one of these areas, you should seek medical help immediately.

Scientists think climate changes may have sparked conditions that increased rat populations on Madagascar, and that forest fires from increased droughts have driven the rats and fleas towards inhabited areas.  We should expect to see more instances of disease shifts due to climate change in the future, bringing a factor of unpredictability to our ability to control diseases worldwide.

For more with Professor Barry Fox, check out “Infectious Diseases,” on The Great Courses Plus!

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