A staggering 82 health workers have been struck down by the disease – about around four per cent of the total number of cases – according to latest figures from the World Health Organisation (WHO).
The news has added to fears Madagascar’s health system will be left unable to cope as the outbreak continues to claim more victims.
There are also fears the disease could develop a resistance to the antibiotics being used to treat victims, which would likely see the number of cases surge.
According to the latest update from WHO, 346 healthcare providers “have been trained on infection prevention and control measures at various health facilities”.
Professor John Joe McFadden from the University of Surrey said: “Fortunately in plague, it has not developed much antibiotic resistance.
“If that kicks in, the plague will be far, far scarier.
“If you throw more and more antibiotics at patients, antibiotic resistance is more or less inevitable.”
Madagascar generally sees around 400 cases of bubonic plague every year, but two-thirds of this year’s outbreak are classified as pneumonic, a type of plague which spreads more easily.
At least 2,119 cases of the plague have been reported and the death toll is continuing to rise with the disease having now claimed 171 lives, according to latest WHO figures.
Health officials have warned more cases are expected to be recorded.
The WHO website states: “Based on available information and response measures implemented to date, WHO estimates the risk of potential further spread of the plague outbreak at national level remains high.”
Meanwhile, neighbouring islands in the Indian Ocean, which include holiday hotspots like Mauritius and the Seychelles, remain on alert and are prepared for any outbreaks.
The WHO adds: “The risk of international spread is mitigated by the short incubation period of pneumonic plague, implementation of exit screening measures and advice to traveller to Madagascar, and scaling up of preparedness and operational readiness activities in neighbouring Indian Ocean islands and other southern and east African countries.
“The overall global risk is considered to be low.”
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.”
Médecins Sans Frontières (MSF) said: “Three types in the current outbreak in Madagascar: the bubonic, pneumonic and septicemic plague.
“What makes this outbreak exceptional is the wide occurrence of the most lethal form of plague, the pneumonic plague that is also the only form that spreads from human to human.”