January 4, 2014
Black Death Lives On In Madagascar
Plague, also known as the Black Death, is one of the most virulent and deadly diseases known to man. The very name strikes fear into hearts even though it is now extremely rare on a global scale. But in some parts of the world it still reaps a terrible harvest each year and is proving hard to eradicate. In early December this year, a new outbreak in Madagascar brought the problem into sharp focus.
There are hundreds of hundred cases of plague reported every year in Madagascar and according to the World Health Organization, 2012 saw the country become the most seriously plague-infected country in the world when there were 256 cases and 60 deaths but 2013 seems to have been particularly bad. The latest outbreak alone saw up to 40 deaths among more than 80 reported infections and what is most worrying is that the latest victims were suffering from what is thought to be pneumonic or pulmonary plague which is usually considered to be the deadliest strain of the disease.
Madagascar has suffered from falling standards of living, general health, and hygiene since a coup in 2009 destabilised the country and its economy. Health workers believe that the main source of infection comes from the island’s overcrowded prisons where hygiene is at its worst. Rat infestation is common in the island’s prisons and plague is spread to humans through bites from fleas that carry the infection from rats. The International Committee of the Red Cross issued a stark warning in October saying that “Rat control is essential for preventing the plague because rodents spread the bacillus to fleas that can then infect humans. So the relatives of a detainee can pick up the disease on a visit to the prison”. Also, they warned, a released prisoner can carry the disease back to his community.
Although a lot is being done by health workers to bring the problem under control, they seem for now to be fighting a losing battle. One of the factors making things harder is that pneumonic plague does not rely on humans actually being bitten by fleas. The same bacteria – Yersinia pestis – is involved in both pneumonic and bubonic plague but the latter relies on flea bites to spread while the pneumonic variant can be spread by inhalation of the bacteria from the coughs of a previously infected human. The disease can be treated if caught early but death can occur in as little as 24 hours if no treatment is given. The death rate can be as high as two in three in the first four days.
It is estimated that over 25 million people, or up to 60 percent of the population, died in Europe during the Great Plague of the 14th century. Some historians have even suggested that, because the plague wiped out so many working age people, labour was in great demand and wages increased accordingly. This, they say, gave a significant impetus to European economic development.
It is easy to see why this disease is still so much feared around the world and why every effort is being made by world health officials to keep it under control.
Image Credit: Thinkstock