Pest in Madagascar claims 60 deaths

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Pest in Madagascar claims 60 lives and 200 people have been infected

The plague rages on Madagascar (Latin pestis = epidemic). According to official information, 60 people have already died of a plague disease in the south-east African island state since the beginning of the year. Cases of the extremely contagious infectious disease have been reported from almost all regions of Madagascar, the responsible health authorities report.

Hundreds of Madagascar residents are suffering from the plague. Health authorities were extremely concerned not only about the rapid spread of the infectious disease, but also because some strains of pathogens have already developed extensive resistance to antibiotics. "If these strains continue to spread, it will cause serious problems for public health," warned pest expert Elisabeth Carniel from the Parisian "Institut Pasteur" in a report by the television station "ZDF".

Antibiotic-resistant pest pathogens? The spread of the plague is also problematic, according to local medical experts, because the treatment options are not designed for the rapid spread of the disease. "We are very concerned," emphasized Bruno Maes from the UN Children's Fund UNICEF in Antananarivo, the capital of Madagascar. The ignorance of the population in dealing with the dangerous infectious disease is a further problem, according to the expert. For example, the infected people often come to the doctor far too late "for fear of not being able to pay for the medication". But the preparations are basically free of charge, explained Bruno Maes. According to the health authorities, around 200 people in Madagascar are currently infected with plague, and 60 people have already died of plague since the beginning of the year. Usually, a plague disease can be successfully treated with antibiotics relatively easily. However, multiple resistant bacteria have been detected in the pathogen strains occurring in Madagascar. According to the French pest expert Elisabeth Carniel, the most dangerous pest strain is already immune to eight of the antibiotics recommended by the World Health Organization (WHO). If these resistant pest pathogens spread, disease threatens to a long forgotten extent.

Plague not defeated even in industrialized countries Although the plague has long been a thing of the past in Europe, the plague is nowhere near defeated worldwide. Plague outbreaks occur again and again, especially in regions where humans and rats live together in a confined space. Because the plague is primarily transmitted to humans through the bite of rat fleas. Poor regions are usually more affected, since the rats live in the immediate vicinity of the people or - as is currently the case in Madagascar - flee to the villages and towns during the rainy season or during regular floods. But even modern industrialized countries are not protected from the outbreak of the plague. For example, plague infections occur repeatedly in the southwestern United States, with around ten to twenty people suffering from the highly infectious disease every year. An outbreak of the plague was also recently reported from China. Overall, however, African states have mostly been affected by the outbreak of pests over the past ten years.

Health care in Madagascar Outbreak of pesta outbreak Madagascar was last plagued in 2009 when 18 people died as a result of an outbreak of the disease. According to the experts, the fact that the disease has now broken out again in the world's second largest island country is due to the steady erosion of health care in Madagascar. In the wake of the coup attempts and government upheavals in recent years, the situation for the residents has deteriorated drastically and it remains to be doubted whether the transitional government that has been ruling since the end of March 2009 and has not been democratically legitimized can cope with the current spread of plague on its own. In the island nation, according to the Human Development Report 2009: Madagascar, there are only 29 doctors for every 100,000 people, and government spending on health care is less than $ 30 per inhabitant annually. According to the United Nations (UN), less than half of the population has access to clean drinking water and more than 70,000 children die of preventable diseases such as diarrhea, respiratory infections or malaria every year before their fifth birthday.

Is the plague returning? According to the experts, the fact that antibiotic-resistant pest pathogens are apparently in circulation in Madagascar is a threat to public health that should not be underestimated. In order to visualize the devastating proportions of the epidemic if antibiotics cannot be treated, we should remember the Europe of the Middle Ages. Here the plague reached its peak in almost half of the population and shaped society like no other disease. Due to the improved hygiene situation, a comparably catastrophic course of the disease is unlikely despite potentially resistant pathogens, but in Madagascar rats and humans live together in a confined space, especially in the current rainy season, so that the transmission of pest pathogens is favored by the rat fleas. If the usual antibiotics fail, the plague could spread dramatically. (fp)

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Image: Gerd Altmann,

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