ANTANANIVARO, Wisconsin —Last fall, the African island nation of Madagascar saw an outbreak of the bubonic plague.
An analysis of the epidemic suggests that a city in the country called Beranimbo was the epicenter of the outbreak. Statistics indicate the country saw 32 reported deaths out of some 84 cases. And the outbreak was thought to have started following the unburied body of a maize farmer.
The disease, triggered by the bacterium Yersinia pestis, is caused by a bite from either an infected rat or flea. With an incubation period of several days, flu symptoms quickly appear. Painful lesions develop with the onset of gangrene and vomiting blood. Eventually seizures, confusion, coma and internal hemorrhaging occur. Quick treatment with antibiotics is necessary to avoid death.
The outbreak saw instances of the pneumonic or pulmonary strain of the disease, a strain that is thought to be more severe. This is because, unlike the bubonic strain, pneumonic or pulmonary plague can be transmitted to humans by water droplets in the air rather than through infected animals or fleas.
Eventually, officials feared that the disease could affect the nation’s prisons where rat populations often carry infected fleas. Luckily for Madagascar’s residents, this did not transpire.
Putting the epidemic in a socioeconomic framework, however, highlights how such a disease is able to spread so quickly and affect so many people.
The slums of some of Madagascar’s poorest areas mirror the living conditions in Europe during the Middle Ages. Impoverished human beings, occupying small, tight spaces with one another, allow for diseases to spread quickly.
Some of Madagascar’s cities feature men, women and children walking barefoot through streets littered with trash and human waste. In the rural areas of Madagascar, villagers are often underweight, malnourished and lack sanitation infrastructure. In turn, much of Madagascar lacks sanitation facilities, health care and other basic services.
Yet last year’s outbreak in the country was not its first. One of the possible reasons the plague has made such an impact upon Madagascar in the past several years is due to a 2009 coup. The event caused political upheaval in the nation.
Following years of socioeconomic misfortunes, the nation elected Marc Ravalomanana as president in 2001. The election and subsequent presidency brought political and economic stability to the country for the first time in decades. This changed in 2009 following a coup that brought an end to elected government, foreign aid and a stable economy. In 2012, Madagascar saw 60 deaths from the bubonic plague.
As history indicates, the Middle Ages saw the disease cause millions of deaths and decimate a third of Europe’s population. Today, the plague predominantly affects developing countries. Around 2,000 cases are reported worldwide each year.
Even though the plague is most known for its effects on the citizens of the Middle Ages, the disease has been attacking humans for much longer. It was first reported to kill the Philistines in 1320 B.C.
The disease has seen three pandemics in human history. These include an episode in the sixth century, the Black Death of the Middle Ages and the potentially still-occurring third pandemic that began in the 1800s. It is now thought that all three epidemics originated in China. Antibiotics appeared in the 1930s to help thwart to the disease in the developed world. Warm, humid seasons see the highest number of cases involving the plague.
Scientists now believe that the plague in the Middle Ages most likely featured instances of the plague in pneumonic form. Because the pneumonic form of the plague is spread through water droplets, this could explain how the disease was able to travel quickly throughout Europe’s cities. Since cases of the plague still appear in areas worldwide, some scientists believe that human beings are still living through the third pandemic.
Because so many animals in the country carry the disease, coupled with other socioeconomic conditions, Madagascar is a difficult place to eradicate the disease. If communities suffer food shortages, rat populations drop significantly. This causes the flea population to grow quickly, and in the process, permit human beings to serve as new hosts.
Yet Madagascar, though notable for its cases of the plague, is not alone. Zambia, India, Malawi, Algeria, China, Peru and the Democratic Republic of the Congo have all seen cases of the disease in recent years. The United States sees, on average, around seven cases of the plague each year, usually in the bubonic form.
To date, some 300 million have perished due to the illness.
Thus, while history often repeats itself for the worse, in the case of Madagascar, alleviating poverty in the region may help to stop the plague.
– Ethan Safran
Sources: Vice, BBC, The Guardian, The Atlantic, New York Times, Nature