By Alexandra Sifferlin
November 2, 2017

The country of Madagascar has been hit with a plague that has spread quickly, infecting nearly 2,000 people. The plague is a deadly disease spread largely by flea bites, but today can be treated effectively. Here’s what you should know about the latest outbreak.

What is the plague?

The plague is a bacterial infection that is typically spread via flea bites. Symptoms can range from fevers to tender lymph nodes. Typically the symptoms will start to appear between two to six days after a person has been bit, according to the U.S. Centers for Disease Control and Prevention (CDC). If the plague is not treated, it can sometimes spread into the lungs, resulting in pneumonia. This is called a “plague pneumonia,” according to the agency, and it is the only kind that can spread between people. While the plague used to be cause for pandemics, today it can be successfully treated with antibiotics.

Are there different types of plague?

There are three main types of plague: bubonic, septicemic and pneumonic. More than 80% of plague cases in the U.S. are bubonic, which causes fever, headache, chills and weakness, the CDC says.

What’s happening in Madagascar?

Every year, there are an estimated 400 cases of bubonic plague reported in Madagascar. However, starting in August there has been plague pneumonia spreading in highly populated areas of the country. The World Health Organization reports that there are around 1,800 cases, and 127 deaths. “This outbreak is unusually severe, and there are still five more months to go before the end of the plague season,” the WHO wrote in a Thursday statement about the situation.


Is the plague common?

No. In the United States there are an average of seven human plague cases reported each year, according to the CDC. Globally, there are typically about 1,000 to 2,000 cases reported globally every year.

Is it deadly?

It can be, if people are not treated quickly. Thanks to the availability of antibiotics, the death rate from plague is about 11%, according to the CDC. Before antibiotics, experts say the death rate was closer to 66%.

How are public health officials responding?

The WHO says it has been working closely with the Madagascar government. The agency says it has delivered about 1.2 million doses of antibiotics and $1.5 million dollars in emergency funds to Madagascar. WHO members have also been helping the country do airport plague screenings, as well as helping nearby countries prepare for potential cases and increase surveillance.

Contact us at editors@time.com.

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