An epidemic of the deadliest form of plague, pneumonic, has hit major cities and towns in Madagascar and is spreading fast. As of 7 October, the Madagascar Health Ministry reported that 343 people had been infected and 42 died, and numbers are rising rapidly.
A massive response is underway, and the World Health Organization (WHO) is on high alert. This poor island nation is regularly hit by plague outbreaks, but they are typically the relatively less dangerous bubonic form, transmitted from rats to humans by fleas, and occur largely in remote areas. Bubonic plague killed an estimated 60% of Europe’s population during the Black Death in the 14th century.
What’s particularly alarming now is that pneumonic plague is easily transmitted person to person by coughing, and the outbreak has reached relatively densely populated urban areas, including the capital, Antananarivo, commonly known as Tana. Left untreated with antibiotics, pneumonic plague is 100% fatal. (Both forms are caused by the bacterium Yersinia pestis; pneumonic plague develops when a person with bubonic plague is not treated, and the infection spreads to the lungs.)