More than 100 people have died in the latest outbreak of the fatal disease in Madagascar, with more than 1,500 infected with the disease.
The World Health Organization (WHO) have issued an alert on the island and across nearby South Africa, Kenya, Ethiopia, Mozambique, Tanzania, Comoros, Mauritius, Reunion and the Seychelles.
The plague is a highly infectious disease spread by small animals, such as rats, and fleas carrying the Yersinia pestis bacteria.
The WHO warns that the bubonic plague has a fatality rate of 30 per cent to 60 per cent, and the more deadly variant, the pneumonic plague, is always fatal if not treated.
Why is the plague back?
Despite the common misconception that the plague was eradicated, outbreaks of the disease are still in fact regular occurrences around the world.
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The WHO reported 3,248 infections and 584 fatalities between 2010 and 2015.
Madagascar suffers from seasonal outbreaks of the bubonic plague every September and April. But this year the island has also been struck with a much worse outbreak of the pneumonic plague.
It is thought a macabre local ritual involving the digging up of bodies may be linked to the outbreak this year.
The ritual of ‘famadihana’ sees families dig up the bones of the deceased to have them re-wrapped in linen and paraded through the streets.
Willy Randriamarotia, Madagascar’s health ministry chief of staff, said: “If a person dies of pneumonic plague and is then interred in a tomb that is subsequently opened for the ritual, the bacteria can still be transmitted and contaminate whoever handles the body.”
Where did the Black Death plague spread in Madagascar?
The point of origin for the outbreak was traced back to the capital Antananarivo and the port city of Toamasina in the Ankazobe District in the Plateaux of Madagascar.
But officials are now concerned that the fatal disease will continue to spread across the island.
An official bulletin from the Madagascar health ministry warned that the movement of people is one of the main factors behind the spread of the disease.
How is the Black Death plague spread?
The bubonic plague is spread when fleas carrying the Yersinia pests bacteria bite humans. But the pneumonic plague can be spread from human to human through spit and droplets of cough.
What are the symptoms of the Black Death plague?
The first symptoms of the plague usually include sudden onsets of fevers, chills, weakness, aches, nausea and vomiting.
How can the Black Death plague be treated?
Antibiotics are usually a sure method of combating the disease. If left untreated, the plague can be fatal.
The WHO said: “Antibiotics and supportive therapy are effective against plague if patients are diagnosed in time.
“Pneumonic plague can be fatal within 18 to 24 hours of disease onset if left untreated, but common antibiotics for enterobacteria (gram negative rods) can effectively cure the disease if they are delivered early.”