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Never mind the plague, come on over

November 9, 2017 Headline News No Comments Email Email

Various strains of plague, including the dreaded medieval “Black Death”, have broken out in Madagascar. The World Health Organisation (WHO) is concerned the outbreak could reach mainland Africa – but three Indian Ocean countries issued a statement yesterday reassuring travellers that there’s no reason to be afraid to visit the region.

The plague outbreak has led health authorities to advise Madagascans to stop the traditional practice of famadihana, or “the turning of the bones”, in which people dig up the bodies of their ancestors from family crypts, rewrap them in fresh cloth, then dance with the corpses around the tomb to live music before re-burying them.

Concern has been expressed that recent outbreaks of bubonic plague may be caused by contact with bacteria living on the deceased.

Famadihana ceremony. Wikipedia Commons

The World Health Organisation (WHO), meanwhile, has requested that nine countries and overseas territories in the African region – Comoros, Ethiopia, Kenya, Mauritius, Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania – make preparations for a potential outbreak.

In a joint statement at the sidelines of the World Travel Market in London, the tourism ministers of Madagascar, Mauritius and Seychelles expressed confidence in the measures being taken by Madagascar to overcome the plague outbreak. None of those three countries are affected by the current plague outbreak in Madagascar and they are determined to keep it that way.

“Ministers recalled that all countries are taking the measures recommended by the World Health Organisation (WHO), and expressed their confidence that these are going on the right direction,” an issued statement said.

UN World Tourism Organisation Secretary-General Taleb Rifai said WHO did not recommend any travel bans on Madagascar and that “based on the available information to date, the risk of international spread of plague appears very low”.

The Black Death. A medieval interpretation


Air Seychelles has suspended direct flights to Madagascar as a precaution.

Data issued a few days ago said plague numbers on Madagascar had risen nearly 40% in less than a week, and an estimated 1800 people on the island now carry the disease, while 127 people have died of it.

While the lethal epidemic could infect over 20,000 people in a few weeks if the increase continued at the same rate, health authorities are fighting back and the World Bank has released an extra USD 5 million to bolster their efforts. The money will help fund medical personnel, the disinfection of buildings and living spaces, and the purchase of fuel for ambulances.

About 98% of the world’s plague cases occur in Africa and three variants are involved in Madagascar. The first is bubonic, the type nicknamed the “Black Death” or “Black Plague”, which ravaged Europe and the Mediterranean in 14th century, killing up to 60% of those who caught it. In England, on average, between 30-45% of the general population died in the Black Death visitation of 1348-50. In some villages, 80% or 90% of the population died.

The second strain is pneumonic plague – a powerful strain of the Yersinia pestis bacterium with a very high mortality rate unless treated early.

Pneumonic plague attacks the lungs and spreads person-to-person through droplets from coughing, like a cold, while bubonic plague spreads only from fleas to humans. WHO says about 70% of cases in Madagascar so far have been diagnosed as pneumonic plague.

The third strain, septicaemic, a life-threatening infection of the blood, is the rarest of the three.

Australia’s Department of Foreign Affairs and Trade has issued two relevant travel advisories. The first, on Madagascar, states:

“In September 2017, deaths suspected to be associated with the pneumonic plague were reported in the regions of Toamasina, Moramanga and Antananarivo. Pneumonic plague is spread from person to person by respiratory droplets in the air. Affected persons experience flu-like symptoms. Practice good hygiene and speak to your health provider before travelling.”

DFAT’s official advice for Madagascar is “exercise a high degree of caution”.

The second, relating to the Seychelles and issued on 14 October 2017, states:

“Following the plague epidemic in Madagascar, authorities are restricting travellers entry from Madagascar and Air Seychelles has suspended direct flights to Madagascar. Travellers arriving or transiting through Seychelles from Madagascar will have the option to go back immediately or go into an isolation centre for six days. Contact your tour operator or the airlines for latest update.” 

DFAT’s official advice for Seychelles is “exercise normal safety precautions”.

WHO’s advice is:

“International travellers arriving in Madagascar should be informed about the current plague outbreak and the necessary protection measures. Travellers should protect themselves against flea bites, avoid contact with dead animals, infected tissues or materials, and avoid close contact with patients with pneumonic plague.

“In case of sudden symptoms of fever, chills, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tainted sputum, travellers should immediately contact a medical service.”

Written by Peter Needham

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