The black plague is back, but you could say it was never dead to begin with. In reality, the presence of the plague in Madagascar is a yearly occurrence. Back in November of 2014, 119 cases were recorded, including 40 casualties. However, the cases that stemmed from the deadly pneumonic (airborne) form of the plague were just 2%. Judging from the quick spread of the disease in 2017, this percentage has seen a significant increase. August 27th marked the first occurrence, and by September 23rd the plague was certified as an outbreak.
For the first time, the disease isn't limited to remote areas; Madagascar's densely populated urban centers (the capital included) have been hit hard. As of October 12, 2017, 343 people have been infected and 48 have died. This might go down as one of the most contagious modern cases of the black plague, but it raises the question of "why now?" The factors that brought about this latest outbreak were a perfect of storm that may have started brewing as early as 2009.
Officials In Madagascar Declared The End Of The Plague In November 2017
A round of the bubonic plague that started in August 2017 and claimed over 200 lives in Madagascar was officially downgraded from epidemic status in November 2017. The Madagascan National Tourism Board said no new cases of the illness have been confirmed since November 3, 2017.
The Malgasy Prime Minister, Olivier Mahafaly Solonandrasana, announced the end of the epidemic on November 27, but World Health Organization's official statement says officials must stay vigilant:
The unprecedented outbreak of pulmonary plague, which began in Madagascar last August and has claimed more than 200 lives, is on the decline. The response must, however, be maintained.
Dr. Tedros Adhanom Ghebreyesus, the general director of WHO, stated:
The strongest of the outbreak is behind us but we need to be able to continue to detect cases and intervene until the end of the epidemic season in April 2018. According to data published by the Malagasy Ministry of Public Health, the number of new cases has steadily declined in recent weeks. This shows that the measures taken to control the outbreak have been effective, but new cases of bubonic plague and pulmonary plague are expected until the end of the epidemic season in April 2018.
The Malagasy Ministry of Public health reported 2,348 cases between August 1, 2017, and November 22, 2017; there were 202 confirmed deaths.
Madagascar Is No Stranger To The Plague
The plague isn't a rare occurrence in Madagascar. Actually, it happens almost every year from September to April, which is the rainy season. During this peak season, a minimum of 400 cases of the plague are reported annually. Typically, the outbreaks are caused by the bubonic variety– the form where the disease is transferred to humans from the fleas of infected rodents. While this is the form that wiped out 60% (about 50 million) of Europe's population in the 14th century, it is not the most deadly. The pneumonic variety spreads through the air, making it highly contagious and even harder to contain.
Worldwide, The Plague Is More Alive Than You Think
Between 2010 and 2015, about 3,2348 cases of the plague were reported worldwide. Most instances were not fatal, but 584 deaths did occur. This means that the plague is far more alive than many would expect. In fact, the only continent where it's not found is Oceania. Even the United States experiences an average of seven cases per year.
But some countries are more affected than others, and none of them have it worse than Madagascar. From 2010, the island nation accounts for most of the world's cases. There was one eventful year where 90% of all plague occurrence came out of Madagascar.
A Traveler Sets The Outbreak In Motion
In August of 2017, a man from the east coast of Madagascar contracted the plague during a visit to the central highlands. At the onset, the plague resembled flu-like symptoms, so it's likely the man saw no need to seek immediate medical attention. Four days after he showed symptoms, the man boarded a mini bus to head home. On the way, he passed through the capital and showed signs that the disease had moved to his lungs. It's believed that the man crossed paths with dozens of people; initially, 31 became sick and 4 died. The man himself passed away not long after he reached his destination.