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WHO: 'Normal' Madagascar plague became 'worrisome'

Staff Writer | October 9, 2017
The World Health Organization (WHO) issued a warning about a worrisome outbreak of plague on the African island of Madagascar that has caused 200 infections and 33 deaths since September.
Madagascar plague
Island   The outbreak of plague is an annual occurrence
The outbreak of plague is an annual occurrence in Madagascar, which normally reports about 400 cases per year, usually in the remote island highlands.

What makes this outbreak different, according to the WHO, is that many of the infected live in more densely populated towns and the capital Antananarivo.

Also, the infections reported are pneumatic plague, which is transmitted by air, making it much more difficult to control.

Pneumatic plague is different from bubonic plague, which is the more common form on Madagascar.

Bubonic plague is transmitted when an infected individual is bitten by fleas carried by rats. On Madagascar, the outbreaks are more common in rural rice farming areas and are not as easily transmitted.

Both versions of the plague were the cause of the Black Death epidemic in the mid-14th century, which wiped out a third of Europe's population.

In response to the threat, Madagascar's government has closed schools, businesses and outlawed large public gatherings including concerts and sporting events where the disease could be spread to dozens or even hundreds of people at a time.

The disease is already confirmed to have left the island after several participants in an international basketball tournament displayed symptoms after arriving home.

One coach from the Indian Ocean island nation Seychelles died and another from South Africa was diagnosed but survived.

Other tournament participants are being monitored for symptoms.

Pneumatic plague often appears to present as influenza or a common cold that advances to pneumonia. It is more deadly than bubonic plague.