By: Taylor Eisenstein
According to the Centers for Disease Control and Prevention (CDC), plague is caused by a bacterium called Yersinia pestis, which is carried by fleas and animals such as rats. The bacterium can be transmitted to humans when fleas bite the contaminated animal vector—ingesting infected blood—and then subsequently bite the human host. It can also spread via unprotected contact with contaminated fluids or tissues.
There are three types of plague: bubonic, pneumonic, and septicemic. Bubonic plague is characterized by symptoms including fever, chills, and inflamed lymph nodes called ‘buboes.’ Septicemic plague, in addition to symptoms such as fever, chills, and weakness, may cause tissues to turn black and die. Pneumonic plague additionally involves serious pneumonia with chest pains and coughing; this form of plague is most virulent and is commonly spread from person to person, typically through inhalation of contaminated droplets. The majority of confirmed, probable, and suspected cases in Madagascar were pneumonic, with reports of more than 300 cases of bubonic plague, 1 case of septicemic plague, and additional cases of unidentified plague types.
In Madagascar, the public health response has proven crucial in containing the outbreak. Several preventive measures were taken to prevent further spread: schools were disinfected, posters on hygiene were distributed, and workshops were organized. More than 300 healthcare providers were also given training on plague prevention, while more than 8000 community leaders assisted with surveillance.
Several organizations and other countries have also provided assistance to Madagascar. The United Nations Children’s Fund (UNICEF) has donated items such as tents, beds, and surgical masks, while the WHO has donated 1.2 million doses of antibiotics. China has provided medications, France has donated 255,000 pairs of gloves, and Morocco has sent more than 34 tons of medications and other materials.
The WHO’s Global Outbreak Alert and Response Network continues to monitor cases of plague, and the outbreak is currently waning. According to WHO, the last case of confirmed bubonic plague was reported November 8, while the last case of pneumonic plague was reported November 14. On November 25th, 2017, the Ministry of Health of Madagascar announced that the outbreak was contained. However, because plague season in the country typically lasts from September to April, more cases may arise in the coming months. By maintaining the current response and surveillance methods in future, public health and governmental organizations will hopefully prevent the recurrence of any potential outbreak.