In an article published on the website, MedCity News, author Nicole Oran pens the following–“Quit stressing about Ebola – The bubonic plague is next“. She opens by saying, “OK. Ebola has gotten the nation and the world into a total frenzy, but of course, we’ve got yet another thing to worry about.”

This image depicts a magnified view of an oriental rat flea, Xenopsylla cheopis. Image/CDC
This image depicts a magnified view of an oriental rat flea, Xenopsylla cheopis. Image/CDC


Oran goes on to write about the bubonic plague, which is being seen in outbreak numbers on the island of Madagascar since late August. She mentions that 2 percent of the cases (2-3 cases) are pneumonic plague, “But the part that makes it even scarier than Ebola is that two percent of the Madagascan cases are in the more dangerous pneumonic form, which can be spread between humans through coughing.”

I’m not downplaying this statement, because pneumonic plague  is a dangerous public health issue and difficult to control, especially in densely populated cities. However, Madagascar sees pneumonic plague cases annually.

She closes the article saying, “We don’t want to be a source for hyping up paranoia, but this is getting a little bit intense.”

What Oran doesn’t say is that plague, caused by the bacterium Yersinia pestis, is essentially a mainstay on the world’s 4th largest island. During the first decade of this century (2000-2009), Madagascar saw in excess of 7,000 plague cases, second only to the Congo.

In fact, during the previous decade (1990-1999), Madagascar was the plague leader. Annually, Madagascar sees 300-600 cases with dozens of fatalities. Sub-Saharan Africa and Madagascar accounts for over 95% of reported cases annually.

So plague is no stranger to Madagascar.

It is also treatable with antibiotics when given early in the disease, something we cannot say with the filovirus, Ebola.

However, again I’m not downplaying the current outbreak because clearly this has the potential to get out of control, particularly in the capital city. However, making a comparison to what is happening in the current West Africa Ebola outbreak is really apples and oranges.

Heck, we saw 8 cases of human plague in the United States in 2014 alone.

For those of us writing about outbreaks and infectious disease news for years, this is something we see every year.

Just want to keep things in perspective.