The plague strikes Madagascar killing 30 and triggering panic
Katharina Kreppel
Face masks are placed on children in Antananarivo   Madagascar   on Tuesday . ( Alexander Joe / Associated Press ) Some might consider the plague a thing of the past   buried deep in medieval history . But it thrives in Madagascar   where the disease is a seasonal worry . And this year   the country is experiencing what may be its deadliest outbreak in years : About 194 people are suspected to have fallen ill from the plague since August   and 33 have died as of Saturday   according to Madagascar ’ s Ministry of Health . Experts say they can ’ t remember the last time the death toll was so high . In 2016   63 people died over the course of the year   out of 275 cases . The majority of this year ’ s cases are pneumonic plague   which can be transmitted through coughing   according to the BBC . This form of the disease can kill an infected person in less than a day . To slow the outbreak   Madagascar is temporarily shutting down its public institutions . Government authorities ordered two universities to close   and other schools have shut their doors across the country   including the capital   Antananarivo   so buildings can be sprayed with insecticides . The World Health Organization has shipped more than a million doses of antibiotics to the country   the BBC reported . “ We are scared — all of these deaths show that the situation is serious  ” Miora Herinjatovo   55   told Agence France - Presse on Wednesday . She got a mask from a hospital — unlike her husband   who failed to get one after standing in line outside a pharmacy . He instead collected a handful of generic antibiotics . [ The plague   alive and well in Madagascar ] Experts say the outbreak started in late August   when a 31 - year - old man from the eastern city of Toamasina took a trip inland to Ankazobe   where the plague lives in rodent and flea populations . While there   he came down with malaria - like symptoms . He died in a taxi home   passing through Antananarivo   the WHO said in a Sept . 28 statement . The WHO said that many of the cases identified are directly or indirectly linked to the man   which is evidence of person - to - person transmission . Of the 31 people who made direct or indirect contact with him   four became ill and died   the WHO said . Antananarivo and Toamasina were among the most - infected cities : As of Sept . 30   Antananarivo and its suburbs had 27 cases and seven deaths   and Toamasina had 18 cases and five deaths . Antananarivo has about 1 . 3 million residents   while Toamasina has about 237   000   according to a 2014 count by the National Institute of Statistics in Madagascar . Public gatherings   including jazz festivals and basketball tournaments   have been called off to prevent the plague from spreading   according to media reports . One of the people killed by the plague last week was a basketball coach from the Seychelles   who died while visiting the capital for a tournament   according to a WHO report released Thursday . “ Right now   we have the outbreak of a very infectious   fatal disease  ” said Katharina Kreppel   an epidemiologist at the Ifakara Health Institute in Tanzania   who spent four years conducting field research in Madagascar . “ If people don ’ t notice fast enough   or don ’ t have access to health care fast enough   they die very quickly .” [ There ’ s plague in Arizona . Authorities warn of fleas that can infect people and pets .] This plague shares the same bacterium   yersinia pestis   that caused the “ Black Death ” pandemic in Europe during the 14th century . The most common form of the plague in Madagascar was   until this year   the bubonic plague   spread to humans through infected fleas that contracted the infection from small animals they bit   like rats . The disease is typically spread to humans by the bite of an infected flea   according to the Centers for Disease Control and Prevention . The bubonic plague is often treatable with antibiotics . If left untreated   though   the bacteria can spread through the bloodstream to the lungs and cause pneumonic plague — a deadly   more infectious form that ’ s now spreading throughout Madagascar . Symptoms of the pneumonic plague are similar to the common cold   according to the CDC . The symptoms of bubonic plague are fever   headaches   chills and weakness — as well as one or more swollen and painful lymph nodes   known as buboes . The bacteria multiply in the lymph node closest to where the bacteria entered the body   usually through the infected flea bite   according to the CDC . If an infected person isn ’ t given antibiotics   the bacteria can spread to other parts of the body . Should the bubonic plague become pneumonic   the person will develop shortness of breath   chest pain and sometimes bloody or watery mucous . The pneumonia may cause respiratory failure and shock . All forms of plague   if untreated   can progress rapidly to death   according to the CDC . There have been three major plague pandemics : The Justinian plague   which broke in the Byzantine Empire in AD 541 ; the “ Black Death  ” which originated in China in 1334 and spread to Europe ; and the Modern Plague   which began in China in the 1860s and appeared in Hong Kong by 1894   according to the CDC . It was during the last pandemic that scientists identified the link between the bacteria and infectious flea bites   and rat - associated plague was soon brought under control in most urban areas . The plague has since been controlled in most countries with insecticides   according to the CDC . And since it can be treated with antibiotics   the spread of the disease is usually prevented if promptly identified . The plague is most commonly found in sub - Saharan Africa and Madagascar   areas which account for more than 95 percent of reported cases   according to the CDC . Madagascar often sees the highest numbers of bubonic plague cases worldwide   about 600 infections annually . Madagascar has been in the throes of a political crisis since 2009 and has become one of the poorest countries in the world   with more than 92 percent of the population living on less than $ 2 a day   according to the World Bank Group . It ’ s lost a substantial portion of international aid   and its infrastructure has deteriorated . Once rice harvest season finishes at the end of summer   the rat population drops   as they don ’ t have as much food . Fleas begin looking for new hosts to bite and settle on humans . As it is an island   Madagascar is home to species that transmit the plague and often aren ’ t found anywhere else    Kreppel  told The Washington Post . While Madagascar ’ s scientists have monitored plague patterns for years and have the knowledge to mitigate the spread of this new   pneumonic plague   the money and resources to do so aren ’ t available    Kreppel  said . There isn ’ t adequate funding for insecticides   spraying equipment or antibiotics   she said   and there aren ’ t enough health facilities to house quarantined patients . The country can ’ t afford the vehicles required to travel to isolated villages   should the disease spread further    Kreppel  said . “ If an outbreak like this happened in the U . S . or Europe or anywhere else it would be controlled quite fast   because the resources are there  ” she said . This post has been updated . Read more : The troubling case of the young Japanese reporter who worked herself to death A mother refused to follow a court order to vaccinate her son . Now she ’ s going to jail . Southwest said she was removed from the plane over dog allergies . She has a very different story .
Face masks are placed on children in Antananarivo   Madagascar   on Tuesday . ( Alexander Joe / Associated Press ) Some might consider the plague a thing of the past   buried deep in medieval history . But it thrives in Madagascar   where the disease is a seasonal worry . And this year   the country is experiencing what may be its deadliest outbreak in years : About 194 people are suspected to have fallen ill from the plague since August   and 33 have died as of Saturday   according to Madagascar ’ s Ministry of Health . Experts say they can ’ t remember the last time the death toll was so high . In 2016   63 people died over the course of the year   out of 275 cases . The majority of this year ’ s cases are pneumonic plague   which can be transmitted through coughing   according to the BBC . This form of the disease can kill an infected person in less than a day . To slow the outbreak   Madagascar is temporarily shutting down its public institutions . Government authorities ordered two universities to close   and other schools have shut their doors across the country   including the capital   Antananarivo   so buildings can be sprayed with insecticides . The World Health Organization has shipped more than a million doses of antibiotics to the country   the BBC reported . “ We are scared — all of these deaths show that the situation is serious  ” Miora Herinjatovo   55   told Agence France - Presse on Wednesday . She got a mask from a hospital — unlike her husband   who failed to get one after standing in line outside a pharmacy . He instead collected a handful of generic antibiotics . [ The plague   alive and well in Madagascar ] Experts say the outbreak started in late August   when a 31 - year - old man from the eastern city of Toamasina took a trip inland to Ankazobe   where the plague lives in rodent and flea populations . While there   he came down with malaria - like symptoms . He died in a taxi home   passing through Antananarivo   the WHO said in a Sept . 28 statement . The WHO said that many of the cases identified are directly or indirectly linked to the man   which is evidence of person - to - person transmission . Of the 31 people who made direct or indirect contact with him   four became ill and died   the WHO said . Antananarivo and Toamasina were among the most - infected cities : As of Sept . 30   Antananarivo and its suburbs had 27 cases and seven deaths   and Toamasina had 18 cases and five deaths . Antananarivo has about 1 . 3 million residents   while Toamasina has about 237   000   according to a 2014 count by the National Institute of Statistics in Madagascar . Public gatherings   including jazz festivals and basketball tournaments   have been called off to prevent the plague from spreading   according to media reports . One of the people killed by the plague last week was a basketball coach from the Seychelles   who died while visiting the capital for a tournament   according to a WHO report released Thursday . “ Right now   we have the outbreak of a very infectious   fatal disease  ” said Katharina Kreppel   an epidemiologist at the Ifakara Health Institute in Tanzania   who spent four years conducting field research in Madagascar . “ If people don ’ t notice fast enough   or don ’ [TGT] have access to health care fast enough   [TGT] die very quickly .” [ There ’ s plague in Arizona . Authorities warn of fleas that can infect people and pets .] This plague shares the same bacterium   yersinia pestis   that caused the “ Black Death ” pandemic in Europe during the 14th century . The most common form of the plague in Madagascar was   until this year   the bubonic plague   spread to humans through infected fleas that contracted the infection from small animals they bit   like rats . The disease is typically spread to humans by the bite of an infected flea   according to the Centers for Disease Control and Prevention . The bubonic plague is often treatable with antibiotics . If left untreated   though   the bacteria can spread through the bloodstream to the lungs and cause pneumonic plague — a deadly   more infectious form that ’ s now spreading throughout Madagascar . Symptoms of the pneumonic plague are similar to the common cold   according to the CDC . The symptoms of bubonic plague are fever   headaches   chills and weakness — as well as one or more swollen and painful lymph nodes   known as buboes . The bacteria multiply in the lymph node closest to where the bacteria entered the body   usually through the infected flea bite   according to the CDC . If an infected person isn ’ t given antibiotics   the bacteria can spread to other parts of the body . Should the bubonic plague become pneumonic   the person will develop shortness of breath   chest pain and sometimes bloody or watery mucous . The pneumonia may cause respiratory failure and shock . All forms of plague   if untreated   can progress rapidly to death   according to the CDC . There have been three major plague pandemics : The Justinian plague   which broke in the Byzantine Empire in AD 541 ; the “ Black Death  ” which originated in China in 1334 and spread to Europe ; and the Modern Plague   which began in China in the 1860s and appeared in Hong Kong by 1894   according to the CDC . It was during the last pandemic that scientists identified the link between the bacteria and infectious flea bites   and rat - associated plague was soon brought under control in most urban areas . The plague has since been controlled in most countries with insecticides   according to the CDC . And since it can be treated with antibiotics   the spread of the disease is usually prevented if promptly identified . The plague is most commonly found in sub - Saharan Africa and Madagascar   areas which account for more than 95 percent of reported cases   according to the CDC . Madagascar often sees the highest numbers of bubonic plague cases worldwide   about 600 infections annually . Madagascar has been in the throes of a political crisis since 2009 and has become one of the poorest countries in the world   with more than 92 percent of the population living on less than $ 2 a day   according to the World Bank Group . It ’ s lost a substantial portion of international aid   and its infrastructure has deteriorated . Once rice harvest season finishes at the end of summer   the rat population drops   as they don ’ t have as much food . Fleas begin looking for new hosts to bite and settle on humans . As it is an island   Madagascar is home to species that transmit the plague and often aren ’ t found anywhere else    Kreppel  told The Washington Post . While Madagascar ’ s scientists have monitored plague patterns for years and have the knowledge to mitigate the spread of this new   pneumonic plague   the money and resources to do so aren ’ t available    Kreppel  said . There isn ’ t adequate funding for insecticides   spraying equipment or antibiotics   she said   and there aren ’ t enough health facilities to house quarantined patients . The country can ’ t afford the vehicles required to travel to isolated villages   should the disease spread further    Kreppel  said . “ If an outbreak like this happened in the U . S . or Europe or anywhere else it would be controlled quite fast   because the resources are there  ” she said . This post has been updated . Read more : The troubling case of the young Japanese reporter who worked herself to death A mother refused to follow a court order to vaccinate her son . Now she ’ s going to jail . Southwest said she was removed from the plane over dog allergies . She has a very different story .