The plague, caused by Yersinia pestis, remains endemic in countries such as Madagascar, the Democratic Republic of Congo and Peru. In Madagascar the disease has affected more than 13,000 people over the past 25 years and the fatality rate is 27 per cent. The plague usually appears in rural areas but can reach urban centres. It is mainly transmitted by bites from infected fleas carried by rodents and takes two main forms: bubonic and the more severe pneumonic. Common symptoms include fever, chills and vomiting.
Research led by medical entomologist Adelaide Miarinjara identified the human flea Pulex irritans as a factor in recent outbreaks. Her team analysed cross‑sectional surveys and household flea sampling in four rural villages in the southeastern part of Madagascar’s Central Highlands. They examined household demographics, sleeping arrangements, presence of animals, home hygiene behaviours and attitudes to rodents and fleas.
The study found higher flea infestation in households with large families, traditional homes, livestock kept indoors at night and dirt floors covered with plant fibre mats. Unlike rodent fleas, human flea numbers stayed similar between seasons. The researchers also noted heavy insecticide use, which could lead to resistance. Public health experts recommend coordinated prevention, community education, safer pesticide commercialisation, replacing dirt floors with concrete, housing livestock separately and improving access to affordable flea treatments.
Difficult words
- endemic — Commonly present in a specific region
- fatality — Number of deaths among sick peoplefatality rate
- transmit — To pass a disease from one to anothertransmitted
- pneumonic — A severe form affecting the lungs
- entomologist — A scientist who studies insects
- infestation — Large numbers of pests in a place
- insecticide — A chemical used to kill insectsinsecticide use
- resistance — When pests no longer respond to treatment
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- Which of the recommended prevention measures would be easiest to start in your community? Why?
- How could separating livestock from the house reduce flea problems and disease risk?
- What steps could local health teams take to improve community education about fleas and plague?
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