Up to 60 percent of Europe's population was wiped out by the bubonic plague back in the 14th century. Without treatment, the plague, which is spread by bacteria-infected fleas that live on rats and other small rodents, kills two out of three people infected with the disease. Today, the disease is rare, but it has recently flared up again in Madagascar, where living conditions have deteriorated since the political turmoil of 2009.
Each year, around 500 plague cases are reported in Madagascar, but this year has been particularly bad. As in past years, the problem began in prisons, where crowded, dirty conditions promote the spread of disease. The International Committee of the Red Cross issued a warning in October about the plague threat, writing:
In 2012, Madagascar became the most severely affected country in the world, with 256 cases and 60 deaths according to data from the World Health Organization, which is working in partnership with the Malagasy health ministry to implement a national policy for fighting the plague.
"Rat control is essential for preventing the plague, because rodents spread the bacillus to fleas that can then infect humans," said [ICRC delegate Christopher] Vogt. "So the relatives of a detainee can pick up the disease on a visit to the prison. And a released detainee returning to his community without having been treated can also spread the disease."
Although efforts to eliminate rats from the prison are underway, the disease seems to be getting worse. Health officials confirmed this week that at least 20 villagers have now died from plague,
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