The newest warning about the outbreak of the airborne pneumonic plague, or black death, in Madagascar has been released. Officials warn that it’s inevitable that this bacterial infection that’s infected over 2000 people will become resistant to antibiotics.
The only way to treat a person who has contracted the plague is with antibiotics. But experts now warn that because they are being used so much to treat the infection, antibiotics resistance is inevitable and making this disease much more terrifying. Once the bacteria is resistant, the Madagascar healthcare system will be overwhelmed, and the disease will have control of the nation.
Although the plague is responding well to antibiotics right now, drug resistance is also an increasing concern amongst experts who predict it will vastly accelerate the disease’s death toll. Professor John Joe McFadden from the University of Surrey told MailOnline: “Fortunately in [the] plague, it has not developed much antibiotic resistance. If that kicks in, the plague will be far, far scarier. If you throw more and more antibiotics at patients, antibiotic resistance is more or less inevitable.”
Dr. Derek Gatherer, from Lancaster University’s biomedical and life-sciences department, told MailOnline the country would struggle “to cope” if cases continue to spiral. “Madagascar, typically like many African countries, doesn’t have many doctors. There are around three-and-a-half thousand doctors for 22 million people. They only have around 6,000 hospital beds, so they aren’t particularly well positioned to cope with these kind of events. And if it wasn’t for the international aid coming in things would definitely be much worse for them.”
And experts continue to fear the healthcare system is on the brink of being overwhelmed. Should the disease actually spread to the African mainland, it will be all but impossible to control and the health care system would certainly be unable to handle the outbreak at that point, making a global pandemic much more likely.
The death toll in Madagascar due to the plague has jumped for the first time since health officials claimed the infection was in the beginning stages of control. With the new uptick in those who died, the fear that the disease will spread to the United Kingdom has been confirmed as “100 percent likely.”
The plague death toll has now shown signs that it’s picking up speed again. Official figures reveal 165 people have now lost their lives in Madagascar’s “worst outbreak in 50 years.” Recent data shows a 15 percent jump in fatalities over just three days, coupled with scientists concerned that the black death has reached a “crisis” point. Ten other African countries have also been placed on high alert, warning that an outbreak could occur at any time.
At least 2,034 people have been infected down by a more lethal form of the black death so far in the country, which lies off the coast of Africa, according to WHO statistics. Some experts fear the disease (which is so deadly because it is airborne) could mutate and become untreatable during this year’s outbreak – which is expected to blight Madagascar until April. Others worry the plague will go beyond mainland Africa and eventually reach the US, Europe, and Britain. The plague spreads easily and can kill within 48 hours. That would leave millions more vulnerable to the outbreak, and create a short supply of life-saving antibiotics.
According to the Daily Mail, experts warn the outbreak of plague in Madagascar this year is being fueled by a strain more lethal than the one which usually strikes the country. This form of the pneumonic plague is airborne, easily spread by a cough or a sneeze, and has been responsible for two-thirds of all infections this year. The bubonic form of the plague, responsible for the “Black Death” in the 14th century strikes the country each year and infects around 600 people. But with over 2000 alread infected by pneumonic plague (and counting) health officials aren’t willing to quit sounding alarms just yet.
Paul Hunter, a professor of health protection at the world-renowned University of East Anglia, was the first expert to predict the plague could travel across the sea. He previously said: “The big anxiety is it could spread to mainland Africa, it’s not probable, but certainly possible, that might then be difficult to control. If we don’t carry on doing stuff here, at one point something will happen and it will get out of our control and cause huge devastation all around the world.” There is always a risk with travel that the disease will spread globally, Hunter added.
“We don’t want a situation where the disease spreads so fast it gets out of control. We are talking about it spreading in days rather than weeks.” But Hunter is adamant that a well-developed country could manage the plague should a global outbreak occur. Hopefully, most will never have to find out how well another country can manage this infection.
A few health experts have warned that there is no threat to the UK, however, some have warned the plague outbreak will certainly spread to the region. Richard Conroy, the founder of Sick Holiday, has sent a chilling warning to UK authorities. Conway is saying it’s “only a matter of time” before the disease arrives on British soil. Conroy warned it is inevitable that the plague will spread due to the vast movement of people across the globe. “I believe that it’s 100 percent likely that plague will arrive in the UK once more – it’s just a question of ‘when’, not ‘if’. And it’s not an exaggeration to say that this is a real threat – a ticking time bomb that’s waiting to decimate the world,” Conroy continued. “With the current outbreak still remaining treatable with antibiotics, however, the current risk is low.”
Madagascar isn’t getting this epidemic of the pneumonic plague under control as everyone had hoped. In fact, the opposite seems to be true.
When I wrote about the plague less than two weeks ago, I cited a source that said there were 200 infections and 33 deaths. As of today, those numbers have increased dramatically to more than 1300 infections and 124 deaths. And according to many infectious disease experts, the outbreak has not yet reached its peak. It’s urgent that we stay up-to-date on this epidemic so that we can be prepared if it goes worldwide. (Sign up here to receive a daily update on the topics important to preppers and follow me here for all the most important news links..)
Normally, Madagascar has about 400 cases of plague per year. But this year, it’s worse because it is the pneumonic plague. It gets into the victim’s lungs and is passed through the air from coughing. It’s the most deadly form of a horrific disease, often killing the victim within 24 hours.
Madagascar is a highly populated island with more than 25 million people, and this outbreak has hit the capital city, with more than a million people crammed into an urban environment. There are no real travel restrictions, so flights are going in and out of the international airport, and cargo is still being shipped.
This has led the World Health Organization to issue an international plague warning and to establish response teams in several countries:
Nine countries and overseas territories have been identified as priority countries in the African region for plague preparedness and readiness by virtue of having trade and travel links to Madagascar.
WHO is prepositioning equipment and supplies, including personal protective equipment, antibiotics and other equipment required to safely identify plague cases, in Comoros, Mauritius, Mozambique, Seychelles, and Tanzania.
Due to the increased risk of further spread and the severe nature of the disease, the overall risk at the national level is considered very high. The risk of regional spread is moderate due to the occurrence of frequent travel by air and sea to neighbouring Indian Ocean islands and other southern and east African countries, and the observation of a limited number of cases in travellers. (source)
Another report tells us:
The risk of regional spread is moderate due to the occurrence of frequent travel by air and sea to neighbouring Indian Ocean islands and other southern and east African countries.
Nine countries and overseas territories have been identified as priority countries in the African region for plague preparedness and readiness by virtue of having trade and travel links to Madagascar.
These countries and overseas territories include Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania. (source)
Some of those locations are holiday hotspots and people would be well-advised to consider other vacation plans.
Here’s what the CDC has to say about the pneumonic plague:
Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs. The pneumonia may cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only form of plague that can be spread from person to person (by infectious droplets). (source)
The most apparent symptom of pneumonic plague is coughing up blood. Other symptoms are fever, headache, shortness of breath, chest pain, cough, and sometimes bloody or watery mucous.
Without treatment, the victim will most certainly die.
Pneumonic plague can be treated with antibiotics like streptomycin, gentamicin, tetracyclines, or chloramphenicol but there is a caveat. Treatment MUST begin within 24 hours of the initial symptoms to prevent death. If a person has been exposed to plague, a prophylactic treatment of 7 days of antibiotics can prevent them from becoming ill. Using a close-fitting surgical mask can protect people from contracting plague.
This is the same version of plague known as The Black Death that wiped out a third of the population of Europe during the Middle Ages. With proper intervention, it is unlikely to exact a similar death toll today, but it is still an incredibly dangerous threat.
How do you get prepared for a pneumonic plague pandemic?
First, let me be absolutely clear that at this time, the United States has no cases of plague, nor are Americans at extreme risk. There are no cases of pneumonic plague reported outside Madagascar. However, there are no travel restrictions. Planes and boats are coming and going from the country, so it’s essential to be alert and to watch this carefully. After all, scientists have just warned the world how unprepared we are for a pandemic.
Please remember the almost-catastrophic Ebola pandemic of 2014. It’s essential to prepare for a pandemic well before it ever hits our country because once it arrives, you won’t be able to get the supplies you need in the panic buying frenzy.
If you start to see this epidemic spreading beyond the shores of Madagascar, some common sense preps would not be out of line. Focus on the supplies you need to hunker down and avoid exposure, like a longterm food supply, sanitation supplies, and other items necessary to your family. (You can get a list here.) Be certain to stock up on P100 masks to prevent transmission from an infected person and to prevent inhaling the contagious droplets. If you can’t acquire P100s, get the most protective masks you can get your hands on. (Check out this article for more information on choosing a mask.)
Resources:
To learn more about preparing for a pandemic, read this.
The plague that’s airborne and has killed at least 124 people in Madagascar is now blamed on “dancing with corpses.” This is the time of year when the dead are wrapped in sheets and paraded through the streets while others dance around the bodies.
The local tradition is said to be one of the major causes of the spread of this disease. Since it’s airborne, anyone coming close to the corpse of a person who has died of the black death could themselves, catch the infection. Health officials suspect it’s no coincidence that the outbreak coincides with the time of year when families customarily exhume the remains of dead relatives, wrap them in a sheet, and dance with them through the streets in a sacred ritual, AFP reports.
“If a person dies of pneumonic plague and is then interred in a tomb that is subsequently opened for [the ritual], the bacteria can still be transmitted and contaminate whoever handles the body,” said Willy Randriamarotia, Madagascar’s health ministry chief of staff.
Some locals believe the whole plague is some kind of a government conspiracy, and say they have no intention of forgoing the ritual known as “famadihana.” They say they will continue to dance with the dead and intend to honor their ancestors. “I will always practice the turning of the bones of my ancestors — plague or no plague. The plague is a lie,” Helene Raveloharisoa told the wire service.
Josephine Ralisiarisoa firmly believes the country’s cash-strapped government is just exaggerating the problem to get money ahead of an election next year. And it isn’t that anyone is putting this past a government to lie for profits, but health officials have even warned tourists, a source of money, to stay away from Madagascar for their own health. “I have participated in at least 15 famadihana ceremonies in my life. And I’ve never caught the plague,” she told the AFP.
Face masks are placed on children in Antananarivo, Madagascar (AP Photo/Alexander JOE)
The fears that the “black death” would spread from Madagascar have now taken hold. As nations grapple with the outbreak of the bubonic plague, nine countries are sounding warnings that the disease is spreading rapidly.
The deadly plague outbreak that has struck Madagascar’s major cities has yet to “peak” and that could make the spread of this infection into the surrounding regions more likely. Dr. Ashok Chopra, a professor of microbiology and immunology at the University of Texas, told The Sun Online the crisis in Madagascar had yet to peak. He also sounded the alarm to neighboring countries. Since there are regular flights in and out of Madagascar and this outbreak has so far, been impossible to contain, other nations are now at risk.
Speaking from Madagascar, Christine South, head of IFRC’s (International Federation of Red Cross) emergency operations, said: “With anything like this there is a possibility that somebody could be infected and get on a plane. We have done preparedness support to some of the neighboring countries.” Tourists have been warned to stay out of Madagascar until doctors can get the plague under control to prevent its spread.
The outbreak is considered a much bigger threat to the region than in previous years because it has taken on its pneumonic form. That means it is airborne and spread by sneezing and coughing. Not only that, but the plague has a very short incubation time. Once exposed, some people will die within 24 hours.
Experts say the epidemic could still worsen as the death tolls hit 124 and more than 1,300 are left infected. The World Health Organization (WHO) has now issued alarming warnings in nine countries too. “If they are traveling shorter distances and they’re still in the incubation period, and they have the pneumonic (form) then they could spread it to other places,” said Chopra. “We don’t want to have a situation where the disease spreads so fast it sort of gets out of control. Most of the cases in the past have been of the bubonic plague but if you look at this particular outbreak, 70 percent of the cases are pneumonic plague, which is the most deadly form of the disease. If the treatment is not given in a very short period of time these people will end up dying.”
Both forms of the plague can be cured with antibiotics, but getting treatment quickly is the key to survival.
UPDATE: A man who was diagnosed with pneumonic plague escaped from the hospital and was seen working in the market that serves the capital city.
One of the traders there has already been diagnosed as a carrier of pneumonic plague.
The individual was hospitalised in a specialist clinic in Antananarivo—but discharged himself before completing his treatment.
“Following our efforts to raise awareness about the plague, a group brought in a 24-year-old man who was spitting blood,” said Rabenjaminahobianintra Harimanana, head doctor at the Isotry Central health clinic.
“Tests (for plague) came back positive, so after being given initial treatment he was sent to the Ambohimiandra Anti-plague Clinic.
“But he escaped from the centre and was seen once again trading in the market.”
Authorities sought to reason with him, but he fled again…Hanitra Randrianarison, a senior medical official in Antananarivo, said “this fugitive patient risks spreading the disease very quickly to anyone who gets within two metres (six foot) of him.” (source)
Very little sounds more unsettling than the risk of catching “the plague” but most of us think this is just something that was around during the Middle Ages because of poor hygiene. Unfortunately, that’s incorrect, and to prove it, there is an epidemic of the pneumonic plague in Madagascar right now.
We all remember reading about The Black Death during history lessons in school. It was a horrific pandemic that nearly wiped out Europe, killing a disputed number of people that ranges between 50 million and 100 million. Also known as the pneumonic plague, here is a quick video to get you up to speed on your medieval history.
It’s bad and it’s reminiscent of the Liberian Ebola outbreak in 2013, that alarmingly made its way to American soil. The New York Times reported on the situation in Madagascar:
Since August, the country has reported over 200 infections and 33 deaths.
The outbreak is beginning to resemble the early stages of the West African Ebola crisis in 2014: a lethal disease normally confined to sparsely populated rural areas has reached crowded cities and is spreading in a highly transmissible form.
Schools, universities and other public buildings have closed so they can be sprayed to kill fleas, which may carry the infection. The government has forbidden large public gatherings, including sporting events and concerts.
Fears that the outbreak could spread to other countries are rising.
Late last month, plague struck a basketball tournament for teams from Indian Ocean countries, killing a coach from the Seychelles and infecting another from South Africa. The players are being monitored, Malagasy health authorities told the W.H.O.
Madagascar typically has about 400 cases of plague each year between September and April, but they are usually focused in the nation’s central highlands and spread by fleas living on rats in rice-growing areas. This outbreak is unusually worrying because most new cases are in cities and are pneumonic plague, the form transmitted by coughing. (source)
Madagascar is a large island of 224,533 square miles off the coast of southeastern Africa. It has a population of more than 25 million people in an area that is approximately twice the size of the state of Arizona.
In comparison, Arizona has just over 6 million people, so as you can see, Madagascar is densely populated.
The biggest city on the island is Antananarivo, which has a population of 1,391,433, and concerningly, Patient Zero of the current outbreak traveled through the city by public transit, causing great concern of the possible ramifications.
The Madagascar outbreak started in August, when a 31-year-old man originally thought to have malaria traveled by bush taxi from the central highlands to his home in the coastal city of Toamasina, passing through the capital, Antananarivo.
He died en route and “a large cluster of infections” broke out among his contacts, according to a W.H.O. update issued Oct. 4. Those contacts passed it on to others.
Plague was not confirmed until blood samples collected from a 47-year-old woman who died on Sept. 11 in an Antananarivo hospital of what appeared to be pneumonia were tested at Madagascar’s branch of the Pasteur Institute. The samples came up positive on a rapid test for plague. (source)
Hasn’t Madagascar dealt with the plague before?
Madagascar is no stranger to the plague, with about 400 cases every year, but this time around, it’s the pneumonic plague, which is far more contagious and deadly.
…the majority of cases are of pneumonic plague, which affects the lungs and is transmitted through coughing. It is considered to be the most deadly form of the disease and can be fatal within 24 hours.
The less deadly bubonic plague is often spread by rodents fleeing forest fires. Humans usually become ill after being bitten by infected fleas.
Public gatherings have been banned in response to the latest outbreak.
A specialised hospital in the capital Antananarivo is struggling to cope with the influx of ill people, local media reported, with long queues outside for face masks and medicine.
This year urban areas have been affected, a development that has worried aid agencies in a country not renowned for a robust healthcare system. (source)
Of course, with urban areas comes public transportation, and even more alarmingly for the rest of the world, an international airport. There has already been at least one documented case of pneumonic plague leaving the island, causing Air Seychelles to halt service to Madagascar:
“Following the advice and request of the Public Health Authority of Seychelles concerning the plague epidemic in Madagascar, Air Seychelles will temporarily suspend its services between Seychelles and Madagascar from Sunday 8 October 2017.”
This is the content of the official communiqué of Air Seychelles which will no longer serve Madagascar from tomorrow 08 October 2017.
It is certain that the Seychelles authorities did not appreciate the death of the Seychellois basketball coach in Madagascar following a pulmonary plague he contracted on the spot during the basketball tournament in Antananarivo. It was only after this unfortunate death that the Malagasy authorities took action and began a thorough awareness campaign. (source)
Aside from this, I could find no other travel restrictions to or from Madagascar.
What is the plague?
There are three types of plague: bubonic plague, septicemic plague, and pneumonic plague.
Bubonic plague is spread via infected fleas and small animals. It can result from bites or exposure to the body fluids of dead, plague-infected animals. It can enter through the skin by a flea bite and travel to the lymph system. Treatment with antibiotics must occur within the first 24 hours of symptoms. The mortality rate for those treated ranges from 1-15%, but for untreated patients, ranges from 40-60%.
Septicemic plague is the rarest form of plague and is nearly always fatal without treatment. It attacks the bloodstream. Treatment must begin immediately after symptoms have shown or it will be too late. It is transmitted from flea bites, rodent bites, or mammal bites from infected creatures.
In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), where tiny blood clots form throughout the body, commonly resulting in localised ischemic necrosis, tissue death from lack of circulation and perfusion.
DIC results in depletion of the body’s clotting resources, so that it can no longer control bleeding. Consequently, the unclotted blood bleeds into the skin and other organs, leading to red or black patchy rash and to hematemesis (vomiting blood) or hemoptysis (spitting blood). The rash may cause bumps on the skin that look somewhat like insect bites, usually red, sometimes white in the center. (source)
As awful as the other two versions sound, the pneumonic plague is the most contagious and worrisome. It causes a severe lung infection that is often confused with pneumonia, delaying essential treatment. It can be spread via rodents and flea bites.but also from the sputum of those infected. It can become completely airborne, making it far more difficult to avoid infection.
It must be treated within 24 hours or is nearly always fatal. People who have been exposed to pneumonic plague can be treated prophylactically with antibiotics.
What can be done to treat the plague?
The World Health Organization has sent over a million doses of antibiotics and has protective gear on the way. There are also other measures in place as reported by the BBC.
The authorities have also banned prison visits in the two worst affected areas to prevent the spread of the disease.
The risk of contamination is high in overcrowded and unsanitary jails…
Public gatherings have been banned in response to the latest outbreak.
A specialised hospital in the capital Antananarivo is struggling to cope with the influx of ill people, local media reported, with long queues outside for face masks and medicine.
This year urban areas have been affected, a development that has worried aid agencies in a country not renowned for a robust healthcare system…
On 30 September, Prime Minister Olivier Mahafaly Solonandrasana in a televised statement announced that all public gatherings would be banned in Antananarivo to prevent the spread of the disease following the death of the basketball coach.
In addition to school closures across the country, authorities on 5 October ordered the closure of the country’s two main universities in the eastern port of Toamasina and Antananarivo for disinfection purposes. Sports events have also been cancelled.
There have been concerted efforts to set up rat traps and spray insecticides in several neighbourhoods to prevent the spread of the disease. The government has also established a toll-free number to report any new cases. (source)
The local government is also cracking down on anyone who spreads information that is not in line with the national Ministry of Health.
The Ministry of Health in addition has also taken measures against social media users who it accuses of spreading “false news” on the disease to create panic. A Facebook user was arrested and investigated on 3 October for publishing a report which did not correspond to the toll given by the ministry. (source)
That’s unsettling, isn’t it?
Should we be worried?
At this point, we have no new cases of pneumonic plague in the United States. It has happened before, as one example, when there was an outbreak caused by an infected dog in Colorado in 2015 that then turned into human-to-human transmission. (source) A few months ago, fleas in Arizona were discovered to be carrying the plague. (source)
If untreated, people still can die from the plague, which in the United States occurs in the wild, primarily in rural parts of western states, at a rate of about 10 to 15 cases per year, according to the CDC. Most of the naturally occurring cases are bubonic plague, which can bring on pneumonic plague if left untreated and a person’s lungs become infected.
However, the disease is completely treatable with modern antibiotics if it is diagnosed early.
Worldwide, the World Health Organization reports 1,000 to 3,000 cases of plague each year.
Most infections in the United States have occurred after disposing of squirrels or mice that died from the infection or traveling in an area where infected rodents live. Health officials recommend staying away animals that are lethargic or appear sick. (source)
At this time, we have absolutely no documentation of this bout from Madagascar affecting the United States.
But that doesn’t mean it’s impossible. Never forget that people thought Ebola wouldn’t make it to our shores and it did. The reason it didn’t turn into a full-blown pandemic had absolutely nothing to do with a slipshod official response, either. Read this to learn just how easily an epidemic on foreign shores can turn into a pandemic that affects the whole world.
While the plague is not difficult to treat with antibiotics if caught quickly, one thing that concerns me is the overuse of antibiotics in the United States. They simply don’t work as well for us these days because of near constant exposure from meat and dairy products.
Think of it like a tropical storm, hundreds of miles out to sea. We have no idea if it will reach our shores or how strong it will be, but it’s important to be watchful and ready in case it heads our way. Don’t panic, but be ready to take action to protect your family.
Very little sounds more unsettling than the risk of catching “the plague” but most of us think this is just something that was around during the Middle Ages because of poor hygiene. Unfortunately, that’s incorrect, and to prove it, there is an epidemic of the pneumonic plague in Madagascar right now.
We all remember reading about The Black Death during history lessons in school. It was a horrific pandemic that nearly wiped out Europe, killing a disputed number of people that ranges between 50 million and 100 million. Also known as the pneumonic plague, here is a quick video to get you up to speed on your medieval history.
It’s bad and it’s reminiscent of the Liberian Ebola outbreak in 2013, that alarmingly made its way to American soil. The New York Times reported on the situation in Madagascar:
Since August, the country has reported over 200 infections and 33 deaths.
The outbreak is beginning to resemble the early stages of the West African Ebola crisis in 2014: a lethal disease normally confined to sparsely populated rural areas has reached crowded cities and is spreading in a highly transmissible form.
Schools, universities and other public buildings have closed so they can be sprayed to kill fleas, which may carry the infection. The government has forbidden large public gatherings, including sporting events and concerts.
Fears that the outbreak could spread to other countries are rising.
Late last month, plague struck a basketball tournament for teams from Indian Ocean countries, killing a coach from the Seychelles and infecting another from South Africa. The players are being monitored, Malagasy health authorities told the W.H.O.
Madagascar typically has about 400 cases of plague each year between September and April, but they are usually focused in the nation’s central highlands and spread by fleas living on rats in rice-growing areas. This outbreak is unusually worrying because most new cases are in cities and are pneumonic plague, the form transmitted by coughing. (source)
Madagascar is a large island of 224,533 square miles off the coast of southeastern Africa. It has a population of more than 25 million people in an area that is approximately twice the size of the state of Arizona.
In comparison, Arizona has just over 6 million people, so as you can see, Madagascar is densely populated.
The biggest city on the island is Antananarivo, which has a population of 1,391,433, and concerningly, Patient Zero of the current outbreak traveled through the city by public transit, causing great concern of the possible ramifications.
The Madagascar outbreak started in August, when a 31-year-old man originally thought to have malaria traveled by bush taxi from the central highlands to his home in the coastal city of Toamasina, passing through the capital, Antananarivo.
He died en route and “a large cluster of infections” broke out among his contacts, according to a W.H.O. update issued Oct. 4. Those contacts passed it on to others.
Plague was not confirmed until blood samples collected from a 47-year-old woman who died on Sept. 11 in an Antananarivo hospital of what appeared to be pneumonia were tested at Madagascar’s branch of the Pasteur Institute. The samples came up positive on a rapid test for plague. (source)
Hasn’t Madagascar dealt with the plague before?
Madagascar is no stranger to the plague, with about 400 cases every year, but this time around, it’s the pneumonic plague, which is far more contagious and deadly.
…the majority of cases are of pneumonic plague, which affects the lungs and is transmitted through coughing. It is considered to be the most deadly form of the disease and can be fatal within 24 hours.
The less deadly bubonic plague is often spread by rodents fleeing forest fires. Humans usually become ill after being bitten by infected fleas.
Public gatherings have been banned in response to the latest outbreak.
A specialised hospital in the capital Antananarivo is struggling to cope with the influx of ill people, local media reported, with long queues outside for face masks and medicine.
This year urban areas have been affected, a development that has worried aid agencies in a country not renowned for a robust healthcare system. (source)
Of course, with urban areas comes public transportation, and even more alarmingly for the rest of the world, an international airport. There has already been at least one documented case of pneumonic plague leaving the island, causing Air Seychelles to halt service to Madagascar:
“Following the advice and request of the Public Health Authority of Seychelles concerning the plague epidemic in Madagascar, Air Seychelles will temporarily suspend its services between Seychelles and Madagascar from Sunday 8 October 2017.”
This is the content of the official communiqué of Air Seychelles which will no longer serve Madagascar from tomorrow 08 October 2017.
It is certain that the Seychelles authorities did not appreciate the death of the Seychellois basketball coach in Madagascar following a pulmonary plague he contracted on the spot during the basketball tournament in Antananarivo. It was only after this unfortunate death that the Malagasy authorities took action and began a thorough awareness campaign. (source)
Aside from this, I could find no other travel restrictions to or from Madagascar.
What is the plague?
There are three types of plague: bubonic plague, septicemic plague, and pneumonic plague.
Bubonic plague is spread via infected fleas and small animals. It can result from bites or exposure to the body fluids of dead, plague-infected animals. It can enter through the skin by a flea bite and travel to the lymph system. Treatment with antibiotics must occur within the first 24 hours of symptoms. The mortality rate for those treated ranges from 1-15%, but for untreated patients, ranges from 40-60%.
Septicemic plague is the rarest form of plague and is nearly always fatal without treatment. It attacks the bloodstream. Treatment must begin immediately after symptoms have shown or it will be too late. It is transmitted from flea bites, rodent bites, or mammal bites from infected creatures.
In septicemic plague, bacterial endotoxins cause disseminated intravascular coagulation (DIC), where tiny blood clots form throughout the body, commonly resulting in localised ischemic necrosis, tissue death from lack of circulation and perfusion.
DIC results in depletion of the body’s clotting resources, so that it can no longer control bleeding. Consequently, the unclotted blood bleeds into the skin and other organs, leading to red or black patchy rash and to hematemesis (vomiting blood) or hemoptysis (spitting blood). The rash may cause bumps on the skin that look somewhat like insect bites, usually red, sometimes white in the center. (source)
As awful as the other two versions sound, the pneumonic plague is the most contagious and worrisome. It causes a severe lung infection that is often confused with pneumonia, delaying essential treatment. It can be spread via rodents and flea bites.but also from the sputum of those infected. It can become completely airborne, making it far more difficult to avoid infection.
It must be treated within 24 hours or is nearly always fatal. People who have been exposed to pneumonic plague can be treated prophylactically with antibiotics.
What can be done to treat the plague?
The World Health Organization has sent over a million doses of antibiotics and has protective gear on the way. There are also other measures in place as reported by the BBC.
The authorities have also banned prison visits in the two worst affected areas to prevent the spread of the disease.
The risk of contamination is high in overcrowded and unsanitary jails…
Public gatherings have been banned in response to the latest outbreak.
A specialised hospital in the capital Antananarivo is struggling to cope with the influx of ill people, local media reported, with long queues outside for face masks and medicine.
This year urban areas have been affected, a development that has worried aid agencies in a country not renowned for a robust healthcare system…
On 30 September, Prime Minister Olivier Mahafaly Solonandrasana in a televised statement announced that all public gatherings would be banned in Antananarivo to prevent the spread of the disease following the death of the basketball coach.
In addition to school closures across the country, authorities on 5 October ordered the closure of the country’s two main universities in the eastern port of Toamasina and Antananarivo for disinfection purposes. Sports events have also been cancelled.
There have been concerted efforts to set up rat traps and spray insecticides in several neighbourhoods to prevent the spread of the disease. The government has also established a toll-free number to report any new cases. (source)
The local government is also cracking down on anyone who spreads information that is not in line with the national Ministry of Health.
The Ministry of Health in addition has also taken measures against social media users who it accuses of spreading “false news” on the disease to create panic. A Facebook user was arrested and investigated on 3 October for publishing a report which did not correspond to the toll given by the ministry. (source)
That’s unsettling, isn’t it?
Should we be worried?
At this point, we have no new cases of pneumonic plague in the United States. It has happened before, as one example, when there was an outbreak caused by an infected dog in Colorado in 2015 that then turned into human-to-human transmission. (source) A few months ago, fleas in Arizona were discovered to be carrying the plague. (source)
If untreated, people still can die from the plague, which in the United States occurs in the wild, primarily in rural parts of western states, at a rate of about 10 to 15 cases per year, according to the CDC. Most of the naturally occurring cases are bubonic plague, which can bring on pneumonic plague if left untreated and a person’s lungs become infected.
However, the disease is completely treatable with modern antibiotics if it is diagnosed early.
Worldwide, the World Health Organization reports 1,000 to 3,000 cases of plague each year.
Most infections in the United States have occurred after disposing of squirrels or mice that died from the infection or traveling in an area where infected rodents live. Health officials recommend staying away animals that are lethargic or appear sick. (source)
At this time, we have absolutely no documentation of this bout from Madagascar affecting the United States.
But that doesn’t mean it’s impossible. Never forget that people thought Ebola wouldn’t make it to our shores and it did. The reason it didn’t turn into a full-blown pandemic had absolutely nothing to do with a slipshod official response, either. Read this to learn just how easily an epidemic on foreign shores can turn into a pandemic that affects the whole world.
While the plague is not difficult to treat with antibiotics if caught quickly, one thing that concerns me is the overuse of antibiotics in the United States. They simply don’t work as well for us these days because of near constant exposure from meat and dairy products.
Think of it like a tropical storm, hundreds of miles out to sea. We have no idea if it will reach our shores or how strong it will be, but it’s important to be watchful and ready in case it heads our way. Don’t panic, but be ready to take action to protect your family.
