[Source: The New England Journal of Medicine, full page: (LINK). Excerpt, edited.]
Plague in Madagascar — A Tragic Opportunity for Improving Public Health
Paul S. Mead, M.D., M.P.H.
December 20, 2017 / DOI: 10.1056/NEJMp1713881
When plague first arrived in Madagascar in November 1898, its appearance mirrored events in port cities around the world. Alexandria, Bombay, Buenos Aires, San Francisco, Saigon, and Sydney were all affected as part of the “third pandemic,” a global event that began in China but spread widely with the aid of long-distance steamships. Like the Justinian Plague of 542 c.e. and the Black Death of 1346 c.e., the third pandemic took millions of lives and disrupted societies. Although the disease eventually died out in some regions, enzootic foci established during the third pandemic persist in many areas, including the western United States and the central highlands of Madagascar.
Disclosure forms provided by the author are available at NEJM.org.
The views expressed in this article are those of the author and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.
This article was published on December 20, 2017, at NEJM.org.
Source Information: From the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO.
Keywords: Plague; Madagascar; Public Health.