20 Dead From Plague in Madagascar: Chances of International Spread Increasing

The Guardian is reporting that since October, 20 people have died in Madagascar from bubonic plague. Madagascar is the ‘plague capital’ of the world with about 60 deaths a year from the disease.

From the Guardian:

The Pasteur Institute of Madagascar revealed on Tuesday that tests taken from bodies in the village last week showed that they had died of bubonic plague. The institute added it was concerned the disease could spread to towns and cities where living standards have declined since a coup in 2009.

The deaths are doubly concerning because the outbreak occurred both outside the island’s normal plague season, which runs from July to October, and apparently at a far lower elevation than usual.

Bubonic plague (Yersinia pestis) is spread by the fleas from black rats, Xenopsylla cheopis. Black rats are known by various names. Ship rat, roof rat, house rat, Alexandrine rat and old English rat are all names commonly used to describe Rattus rattus, the black rat.

These rats are found on all continents and the United States is no exception. The fleas from the black rat can live several weeks without feeding and are none to fussy where they get their next meal from. Wild animals, domestic pets and humans are all acceptable food sources.

What makes fleas such a formidable vector for carrying disease is their ability to lie dormant for weeks, or even months, if the conditions are favorable, waking again when they sense vibration, heat and carbon dioxide, the three things that tell them a host, and therefore a meal, is close by.

Madagascar gets some 196,000 international visitors a year according to Trading Economics. Now plague has moved from the higher regions of the island and is active outside what Madagascans call the ‘plague season’. It is only a matter of time before a visitor contracts it, or brings back a flea carrying the disease.

Bubonic plague kills two-thirds of the people it infects within four days if medical treatment is not forthcoming swiftly at the first signs of the disease.

Plague has three forms, bubonic, septicemic and pneumonic. They are all forms of Yersinia pestis. Septicemic and pneumonic plague are 100% fatal if left untreated. Bubonic plague is actually the best you can hope for if you are bitten by an infected flea. Those that do survive bubonic plague are often left disfigured due to gangrene having rotted off fingers and toes. Ends of noses, earlobes and external genitalia are also susceptible to gangrene during the course of the disease.

The United States is ranked 11th highest in the world for plague cases with 57 cases over the last decade. A seven year old Colorado girl, Sierra Jane Downing, was lucky to survive when she was diagnosed with the disease earlier this year. It’s thought she contracted it from a dead squirrel she wanted to bury.

In June 2012, Paul Gaylord (graphic images) of Oregon tried to pull a mouse away from his cat, who was choking on the rodent. The result of that simple action almost killed him and left him severely disabled from gangrene which cased the loss of his fingers and toes.

Although we think of the plague as something from medieval times, these ‘homegrown’ cases and the ongoing outbreak in Madagascar should serve as a reminder to us that the Black Death is still out there.

Sources:

http://animaldiversity.ummz.umich.edu/accounts/Rattus_rattus/

http://icwdm.org/handbook/rodents/RoofRats.asp

http://eol.org/pages/328447/overview

http://www.theguardian.com/world/2013/dec/11/bubonic-plague-killed-villagers-madagascar

http://discovermagazine.com/2006/dec/20-things-rats#.UqjDNaU0H8s

http://travel.state.gov/travel/cis_pa_tw/cis/cis_957.html

http://www.tradingeconomics.com/madagascar/international-tourism-number-of-arrivals-wb-data.html