The bubonic plague? It’s still out there

Health workers in Madagascar are fighting an outbreak of the plague. The large island nation off the southeast coast of Africa actually deals with a “plague season” between September and April every year, but the outbreak is grabbing headlines because there are an unusually high number of confirmed or suspected cases — about 1,800, according to the latest World Health Organization (WHO) estimates.

The fact the plague still exists catches some people by surprise, says Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.

“When we think about the plague, we think about the 1300s when, you know, a half of Europe died,” Bogoch said. “[But] it exists in nature and it has existed in nature for millennia and it will continue to exist in nature.”

The plague is an infection caused by bacteria, called Yersina pestis, spread between rats and other rodents through flea bites. It’s rare for humans to contract the plague, Bogoch said, because they would have to be in close contact with rodents to be bitten by a flea carrying the infection. In that case, they would likely get bubonic plague, which causes swelling of the lymph nodes.

But if the infection spreads into someone’s lungs, it can transform into pneumonic plague — and then it can be transmitted to another person through coughing.

It’s an extremely serious disease that can kill you if left untreated, Bogoch said.  But the good news is that doesn’t have to happen because it’s easily cured with common antibiotics. That — in addition to improved hygiene and sanitation over the past several centuries — is why we don’t often see plague move from its natural habitat among rodents to humans.

The challenge in Madagascar and other countries with less developed health-care and public health systems, Bogoch said, is to make sure people get tested during a plague outbreak and that they have access to the necessary antibiotics.  That’s why the WHO has stepped in to help with the increased number of cases this year — although no one knows exactly what caused the rise, he said.

Last summer, the bacteria that causes the plague was actually found in a Saskatchewan prairie dog. The risk to humans was very low — in fact, the last recorded case of the plague in Canada was in 1939.
Photo: A girl wears a face mask inside a hospital in Madagascar’s capital, Antananarivo, in October, as health workers battle an outbreak of the plague. Though it can be deadly if left untreated, the plague is a bacterial infection that can be easily treated with antibiotics. (Alexander Joe/Associated Press)

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