n some countries, particularly Madagascar, plague is endemic, and flare-ups cause public health emergencies on an almost annual basis — and right now, an uncontrolled epidemic that’s brewing there appears to be exceptionally worrying.
As November 1, more than 1,800 plague cases have been identified, including 127 deaths. Madagascar typically sees about 400 cases each year, when the disease surfaces from September to April. “This outbreak is unusually severe, and there are still five more months to go before the end of the plague season,” the World Health Organization reported. [...]
Also unlike previous outbreaks, this year’s involves mostly pneumonic plague, a more dangerous form of the disease than the much more common bubonic plague. Pneumonic plague attacks the lungs and spreads from person to person through droplets from coughing, like a cold, while bubonic plague spreads only from fleas to humans. (Sixty-two percent of cases so far were classified as pneumonic plague, according to the WHO.) [...]
Because of trade and travel links to Madagascar, there are nine countries and territories that could see plague cases turn up: Comoros, Mauritius, Mozambique, the French regions of Réunion and Mayotte, Seychelles, South Africa, the United Republic of Tanzania, Ethiopia and Kenya. For this reason, the WHO has been beefing up exit screening in Madagascar to make sure people with plague aren’t bringing the bacterium to other countries and helping these nine countries strengthen their epidemiological and laboratory surveillance capabilities. [...]
But there are other factors that help spread plague: Humans have been encroaching on wildlife areas, putting them into contact with potential carriers of the disease. And this is as true for poorer countries as it is for developed places like the US. As this scientific study on US plague reports, "Plague in New Mexico has increasingly occurred in more affluent areas" — the result of building out suburban and exurban communities in previously underdeveloped areas where plague had been circulating in wild animals.
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