Madagascar – 13 February 2015

Bubonic plague strikes Madagascar, 119 cases reported
It might seem ridiculous to worry about the bubonic plague in 2015, but that’s just what the World Health Organization is doing after 119 cases of the disease that ravaged Medieval Europe were identified in Madagascar last year.
“The outbreak that started last November has some disturbing dimensions,” the WHO said in a statement this week. “The fleas that transmit this ancient disease from rats to humans have developed resistance to the first-line insecticide.”
Black Death, or simply the plague, is caused by the bacterium Yersinia pestis, which is spread by rodent-loving fleas. When a human is bitten by an infected flea, they can develop bubonic plague. Symptoms of the plague include swollen, painful lymph nodes, fever and skin color change in extreme cases.
If the infection progresses to the point where bacteria invade the lungs, the disease then becomes known as the pneumonic plague and can be spread by coughing and inhalation.
“If diagnosed early, bubonic plague can be successfully treated with antibiotics,” the WHO statement said. “Pneumonic plague, on the other hand, is one of the most deadly infectious diseases; patients can die 24 hours after infection.”
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Spread of plague slows in Madagascar, death toll at 71: WHO

An outbreak of plague in Madagascar has slowed but 71 people among the 263 known to have caught the disease since last September have died, the World Health Organization (WHO) said on Wednesday.
Madagascar has suffered an outbreak of plague nearly every year since 1980 and case numbers have increased in the past three years, making it the most severely affected country worldwide.
The latest outbreak peaked in November and December but the plague season continues until April. The spread of the disease could have been hastened by heavy rains and flooding in January, the WHO said.
The bacterial disease is mainly spread by flea-carrying rats. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells the lymph node and can be treated with antibiotics, the WHO says.
“However, control of plague outbreaks in Madagascar has been complicated by development of resistance to deltamethrin — the first-line insecticide –- in the fleas that transmit the disease from rats to humans,” it said.
The most heavily affected area, the district of Amparafavarola in the central highlands, had cases of pneumonic plague — the least common but most virulent form of the disease — up to the first week of January, WHO said.
Pneumonic plague can kill within 24 hours and is invariably fatal if not treated.
Thirteen cases of plague were detected in the slum areas of Madagascar’s capital Antananarivo by the end of December, WHO said.