The Plague is Still Upon Us

Mention of the plague usually brings up mental images of the Black Death (the bubonic plague) in the Middle Ages, the high mortality of which brought important demographic changes to a lot of villages in Europe and elsewhere. But the disease is still walking amongst us, as a story by Reuters today points out.

A probable case of plague in the Seychelles, imported from Madagascar, is believed to have sparked the Indian Ocean country’s first outbreak of the disease, the World Health Organization (WHO) said.

Plague, which is mainly spread by flea-carrying rats, is endemic in Madagascar. A large outbreak has killed 57 people since late August, according to the U.N. agency, the first time the disease has appeared in non-endemic urban areas, including in the capital Antananarivo.

Seychelles health authorities reported a probable case of pneumonic plague on Oct 10 in a 34-year-old man returning from a visit to Madagascar, the WHO said. “The patient continues to be hospitalized in isolation until completion of the antibiotic treatment. He is currently asymptomatic and in stable condition,” the WHO said.

Nearly 70 percent of cases in Madagascar have been pneumonic plague, a form spread human-to-human that is more dangerous than bubonic plague and can trigger epidemics. The pneumonic form invades the lungs, and is treatable with antibiotics. If not treated, it is always fatal and can kill a person within 24 hours.

Most of us have never been either to Madagascar or the Seychelles, but that doesn't mean we are immune to the risk of the plague. The US Centers for Disease Control reports that an average of 7 cases per year are reported each year in this country. Note also that while the bubonic plague is usually transmitted by fleas feeding on infected rats, pneumonic plague can be directly passed from one human to another--no fleas or rats required.