Picture: 123RF
Picture: 123RF

SA is among nine countries identified by the World Health Organisation (WHO) as priority areas to be prepared for the plague as the deadly disease spreads through Madagascar.

Madagascar‚ which has travel and trade ties to South Africa‚ has experienced a large outbreak of plague‚ also known as the "black death"‚ since August.

The disease has claimed 124 lives in Madagascar since August 1‚ according to reports‚ and about 1,200 suspected‚ probable and confirmed cases have been recorded so far.

"Plague is an infectious disease found in some small mammals and their fleas. People can contract plague if they are in bitten by infected fleas‚ and develop the bubonic form of plague.

"Sometimes bubonic plague progresses to pneumonic plague‚ when the bacteria reaches the lungs‚" reads the WHO website’s recently updated entry on plague.

The Department of Health has already advised travellers to Madagascar to avoid densely populated areas and to wear surgical masks while in transit.

Screening measures at ports of entry have been enhanced to detect ill passengers‚ and provincial outbreak response teams have been alerted in case there are any reported incidents.

WHO said countries that should remain prepared – due to their travel and trade links with Madagascar – included: Ethiopia‚ Kenya‚ Mauritius‚ Mozambique‚ Réunion‚ Seychelles‚ SA and Tanzania.

Symptoms of plague

• Sudden onset of fever‚ chills‚ head and body aches‚ weakness‚ vomiting and nausea.

• Painful and inflamed lymph nodes can also appear during bubonic plague.

• Symptoms of the pneumonic form appear quickly after infection and include severe respiratory symptoms such as shortness of breath and coughing‚ often with blood-tainted sputum.


To prevent the spread of pneumonic plague‚ avoid close contact (under 2m) with someone who is coughing‚ and reduce time spent in crowded areas. To prevent bubonic plague‚ do not touch dead animals, and wear insect repellent while in plague endemic areas.


Plague can be treated with antibiotics‚ and recovery is common if treatment starts early.

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