A suspected outbreak of pneumonic plague killed seven people in two days in the city of Moramanga, which is situated on a plateau between the central highlands and the east coast of Madagascar, according to a L’Express report (computer translated).
Laboratory testing and patient’s symptoms of fever, headache, tinted blood spitting and sudden death indicate preliminarily the outbreak is due to pulmonary plague.
The suspected outbreak has “dried up” stocks of medicines and overwhelmed the Hospital District Reference (CHRD) of this town, the report notes.
According to Dr. Perfect Rakotoarisoa, attending physician at CHRD Moramanga, since Sunday, eighty thousand doses Cotrim antibiotic were sent to the hospital staff, patients and their entourages.
If confirmed, the seasonal plague in Madagascar may have arrived a little early. The World Health Organization says that the plague is endemic in the country, with epidemic seasonal peaks ranging from September to March.
Plague is an infectious disease caused by the bacterium, Yersinia pestis. It is found in animals throughout the world, most commonly rats but other rodents like ground squirrels, prairie dogs, chipmunks, rabbits and voles. Fleas typically serve as the vector of plague. Human cases have been linked to the domestic cats and dogs that brought infected fleas into the house.
People can also get infected through direct contact with an infected animal, through inhalation and in the case of pneumonic plague, person to person.
Yersinia pestis is treatable with antibiotics if started early enough.
There are three forms of human plague; bubonic, septicemic and pneumonic.
Bubonic plague: This is the most common form. In this form, the bacteria enter the body through the bite of an infected flea or rodent. Here the bacteria infect the lymphatic system. After a few days to week, the person will experience fever, chills, weakness, and swollen lymph glands. These are called buboes.
Untreated bubonic plague is fatal about half the time.
Septicemic plague: This form is also contracted from a flea or rodent bite. Sometimes it appears subsequent to untreated bubonic or pneumonic plague. It involves bloodstream dissemination to all areas of the body. Buboes do not occur. Symptoms are endotoxic shock and disseminated intravascular coagulation. Untreated septicemic plague is nearly always fatal.
Pneumonic plague: Probably the most serious form of plague and it’s when the bacteria infect the lungs and cause pneumonia. It is contracted when the bacteria is inhaled (primary) or develops when bubonic or septicemic plague spreads to the lungs.
Pneumonic plague is contagious and can be transmitted person to person. It is highly communicable under appropriate climate conditions, overcrowding and cool temperatures. Untreated pneumonic plague is frequently fatal.
Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today
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