Plague in Madagascar: not good, but not unusual either

Microbiology in the news again. This time it’s an outbreak of the plague in Madagascar, and it’s causing a bit of a stir.
Now, don’t get me wrong – an outbreak of plague is never a good thing – but once again, a little perspective is called for here. Surprise (and if I may be so bold) “surprise”.

Plague is one of those diseases which captures the public’s imagination, with historical tales about the Black Death sweeping across Europe in the Middle Ages and killing an awful lot of people in its path. And because of that history, plague has a cool nickname and a “superstar” disease status, and news outlets – desperate for clicks – are getting overly excited about it, just like they did with Ebola.

But the fact is that plague is not just a historical disease: yes, it was infamously around a few hundred years ago, but it never really went away. As with many diseases, its prevalence has merely declined due to better hygiene, better education, better pest control and better medical treatment. But even in (supposedly) developed countries like the USA, there are still up to 20 documented cases of plague each year. Worldwide, there are a few hundred reported cases each year, with a mortality rate of around 25%. However, it’s likely that there are many more unreported cases, given that it is now primarily a disease found in rural areas of less developed countries.

The bad news is that Madagascar is a less developed country than the USA (albeit that its gun control laws are somewhat better), and this makes outbreaks of plague (or any other infectious disease) more likely to occur there and more difficult to control once they do.

The better news is that while this is a terrible and potentially disastrous situation, at this point, it’s certainly not unusual. Madagascar is the¬†plague capital of the world (look, it’s not a claim that they stick on their tourism posters) with around 80% of the world’s cases each year, and outbreaks occur almost annually around this time of year, as the temperatures start to rise and the rat and flea populations – vectors of the disease – start to increase.
Additionally, because of this recent history, the authorities will be better set up to deal with the outbreak, despite the challenges mentioned above. And as we saw with Ebola in West Africa in 2014, that’s really important. Also, as long as you can get treated promptly, as a bacterial disease, plague is eminently treatable with simple, basic, cheap antibiotics.

I’m in no way belittling a very serious situation, but if you didn’t get all panicky and excited about the plague outbreaks in Madagascar in, say, 2014 and 2015, then right now there’s really no reason to get carried away about this one either.

Leave a Reply