GENEVA: An outbreak of plague has killed 40 people out of 119 confirmed cases in Madagascar since late August and there is a risk of the disease spreading rapidly in the capital, the World Health Organisation (WHO) said on Friday. So far two cases and one death have been recorded in the capital Antananarivo, but those figures could climb quickly due to “the city’s high population density and the weakness of the healthcare system”, the WHO warned.

“The situation is further complicated by the high level of resistance to deltamethrin (an insecticide used to control fleas) that has been observed in the country,” it added.

Plague, a bacterial disease, is mainly spread from one rodent to another by fleas. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells the lymph node and can be treated with antibiotics, the WHO said.

If the bacteria reach the lungs, the patient develops pneumonia (pneumonic plague), which is transmissible from person to person through infected droplets spread by coughing.

Published in Dawn, November 22th, 2014