Bubonic plague, the disease that wiped out up to one-half of the population of Europe in the 14th century, may break out in the African island nation of Madagascar, health officials have warned.
Government officials, the International Committee of the Red Cross (ICRC) and the Pasteur Institute have commenced a campaign to eliminate rats from prisons on the impoverished Indian Ocean state. The Antanimora prison in the capital city of Antananarivo, which houses some 3,000 inmates, is particularly infested with rats, which spreads the disease by infecting fleas through clothes, bed-sheets and food, thereby infecting humans and other animals.
"The chronic overcrowding and the unhygienic conditions in prisons can bring on new cases of the disease. That's dangerous not only for the inmates but also for the population in general," Christoph Vogt, head of the ICRC delegation in Madagascar, told the Guardian newspaper of Britain
Madagascar records an average of 500 cases of The “Black Death” annually -- last year, 60 people were killed from the plague, making Madagascar the world’s most dangerous place for contracting the disease. "Rat control is essential for preventing the plague, because rodents spread the bacillus to fleas that can then infect humans," Vogt explained. "So the relatives of a detainee can pick up the disease on a visit to the prison. And a released detainee returning to his community without having been treated can also spread the disease."
Last year, some 1600 rats were caught and destroyed by prison and health officials. "The aim is to make sure there is no let-up in the fight against the plague in prisons," Vogt said.
Christophe Rogier of the Pasteur Institute of Madagascar warned the BBC that if the plague gets into prisons, “there could be a sort of atomic explosion of plague within the town.” The prison walls will never prevent the plague from getting out and invading the rest of the surrounding town, he added. "A prison is not a sealed place, first of all the staff themselves who work in the prison are at risk, and they go home at the end of the day, already perhaps being a vector of the disease," ICRC official Evaristo Oliviera told the BBC. "Also the rats themselves, they can go in and out of the jail and also propagate the disease. And the prisoners do have visitors who can be also infected, and the prisoners eventually go out as well so we have many many ‘ins and outs’ for the disease to spread."
Nine out of ten cases of the plague are now recorded on the African continent, with Madagascar and the Democratic Republic of Congo the most vulnerable, accounting for 90 percent of global cases. Cases have also been recorded in other parts of the world in recent years, including Peru, Kyrgyzstan, India, Algeria and Indonesia. “Bubonic plague remains a serious public health problem in many parts of the world,” wrote Imogen Foulkes, a BBC correspondent. “In Madagascar, plague is endemic in the animal population, and cannot be eradicated.”
Not only do the rats have to be killed to stamp out the plague, but so must the infected insects – a very difficult proposition. Still, the disease which killed tens of millions people in Europe between 1440 and 1500, is rare in most regions of the globe. Foulkes noted that the plague had largely disappeared from the European continent in the 17th century.