In an update on the plague situation in Madagascar, an additional case was reported in the district of Tsiroanomandidy in central-western part of the country. This brings the total plague cases to 38 since August 1.

Image/CDC
Image/CDC

A breakdown of the cases reported shows 32 bubonic plague cases, including four deaths and six pneumonic plague cases, of which all have perished.

Tsiroanomandidy district has seen the most cases to date with eight, followed by Befotaka and Manandriana with five each.

Plague is endemic on the Plateaux of Madagascar. Cases are typically recorded from September to April. Although bubonic cases are predominantly reported during the endemic season, pneumonic cases are also expected and are associated with human-to-human transmission and a high case fatality of 30-100% if left untreated.

Plague is an infectious disease caused by the bacterium, Yersinia pestis. It is found inanimals 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.

Related: Congo, Madagascar top countries reporting most plague 2000-2009, US reports 57 cases

Yersinia pestis is treatable with antibiotics if started early enough.

There are three forms of human plague; bubonic, septicemic and pneumonic.