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The Black Plague – Is South Africa At Risk?

Author: Jason Snyman
Date: 2017-10-31
The WHO has put South Africa on alert as a possible destination for the black plague, but is it something we should be worried about?
South Africa has been identified by the World Health Organisation (WHO) as one of nine countries at risk of the black plague. That’s right, the plague, the very same which terrorized Eurasia in the mid 1300's. The black death is one of the most devastating pandemics in human history, estimated to have wiped out up to 60% of Europe’s population. The most recent outbreak of the disease has occurred in Madagascar, which has trade and travel ties to SA. The other countries at risk are listed as Mozambique, Tanzania, Ethiopia, Mauritius, Comoros, Seychelles and La Reunion. Depending on the type of disease the patient has contracted, bubonic or pneumonic, if left untreated the death rate can be 30-100% within 72 hours. Sounds pretty terrifying, but luckily for us, medicine and antibiotics have advanced a little bit in the last 6 centuries.
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Situational Report

The latest report was issued by the WHO on 20 October and published by the NICD (National Institute for Communicable Diseases). The report indicated that, at the time, 1297 cases of the disease had been reported in Madagascar. So far, the death toll stands at over 100. The majority of the cases (65%) are appearing as the pneumonic plague, rather than the common bubonic form. The South African National Health Department have taken a number of precautions to prevent the spread of the disease. Namely:
  • Airline companies have been told to be on alert for ill passengers. Members of the Civil Aviation Authority are undergoing additional training in dealing with suspected cases;
  • Port health officials have put screening procedures into place in order to identify suspected cases arriving in South Africa;
  • Should suspected cases be detected in South Africa, provincial outbreak teams are on alert and will implement safety measures;
  • The NICD will be able to diagnose the disease in their laboratories and is supporting all preparatory measures.
South African travellers to Madagascar are advised to avoid highly populated areas. Generous application of insect repellent is recommended to prevent flea bites, and travellers should monitor their health for 15 days after returning. As conditions can develop rapidly, if any plague symptoms are spotted, those people should immediately consult a doctor.  

Plague Symptoms

The plague is caused by the bacterium, Yersina Pestis, found in some small mammals and transmitted by their fleas. If bitten by these infected fleas, it will develop as the bubonic plague. Two types of plague are most common in human infections. These are the dreaded bubonic plague and the pneumonic plague. The bubonic plague gets its name from the dark swellings, or buboes, at lymph-node sites in the armpits, groin and neck. The disease travels through the lymphatic system to the lymph nodes, where it replicates itself. Luckily, it’s not easily transmitted between people. However, sometimes the disease reaches the lungs, and then it becomes a whole different story. The pneumonic plague attacks via the lungs and is transmitted via body fluids when infected patients cough or sneeze. As a result, an infected patient could infect everybody around them. While the bubonic plague has a natural survival rate of 40-70% when left untreated, pneumonic plague is pretty much fatal. Without the early intervention of modern antibiotics – you will probably die. Early symptoms of the plague include sudden fevers, head and body aches, nausea, chills and shortness of breath. In the case of the bubonic plague, painful lymph nodes may appear. If caught early, the plague can be treated with antibiotics and recovery is common. In areas of outbreak, people who show symptoms should report to a health centre immediately. Patients with the pneumonic plague, however, must be isolated. They are treated by trained professionals wearing protective equipment.
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Reasons Not To Worry

It’s worth noting that we don’t call it the black plague anymore for a reason. Now, it’s just the plain old plague. Back in the Middle Ages, before the age of antibiotics, people’s fingers and toes may have gone black due to the infection in their blood. Today, it’s easily treatable. According to Health24, the antibiotics commonly used include tetracyclines (such as doxycycline), fluoroquinolones (such as ciprofloxacin) and amingolycosides (including streptomycin and gentamycin). Speaking to TimesLIVE, Professor Lucille Blumberg – consultant at the NICD – said the disease hasn’t spread across borders in three months. The disease has been contained in Madagascar since August, with 124 reported casualties. So, if you haven’t been to Madagascar, the chances are slim that you’ll contract the disease. Regardless, SA has one direct flight a week from Madagascar – and all of these travellers are thoroughly screened. Anybody showing symptoms will be sent to the clinic for specialised tests. The reason why so many people have died in Madagascar is because they just aren’t getting the medical treatment they need in time. They may misdiagnose themselves with the flu and just go about their lives until it’s too late. In reality, you’re far more likely to get malaria than the plague, which can also be deadly.
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