(Transcript from SBS World News Radio)
A leading international expert on infectious diseases believes the presence of bubonic plague in Madagascar won't reach the proportions of Ebola in parts of west Africa.
Madagascar's government has declared the disease is at epidemic level in the island nation off the continent's south-east coast.
As Kristina Kukolja reports dozens of people have died since August, and many more are infected, amid fears it could spread further, and fast.
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In the 14th century the bubonic plague, or Black Death as it came to be known, wiped out vast populations in the capital cities of Europe.
600 years later it reached Australia, killing hundreds of people along the east coast.
Professor Sir Richard Feachem is the Director of the Global Health Group at the University of California, in San Francisco.
He says the world won't see a scale of devastation akin to the Black Death arising from the Madagascar outbreak.
"[The] plague is a bacterial disease. It's readily treatable and it tends to flare up in conditions of poverty where you have the rat population and the fleas and the people and the transmission from person to person, partly by the fleas, but it's treatable. So there is not a danger of a global epidemic for the plague, but there certainly are circumstances around the world where plague flares up and national efforts have to be galvanised to bring it back under control."
The World Health Organisation is taking the emergence of the plague in Madagascar seriously.
According to the WHO, antibiotics can be used to treat the bubonic form, thought to be caused by rat flea infection.
Of particular concern, though, would be the pneumonic phase, when the bacteria reaches the human lungs.
That's when even a cough can cause it to spread.
And once the bacteria becomes airborne it's regarded as one of the most deadly infectious diseases, able to kill a person in under 24 hours.
Very few of the cases reported in Madagascar have been pneumonic.
But Prime Minister Kolo Christophe Laurent Roger says a national action strategy is being implemented to limit the contagion.
(Translated) "For each case all the necessary measures have been taken into account to stop the spread, and all cases whether far away or in the capital of are being dealt with seriously."
The World Health Organisation says the plague has reached the capital Antananarivo, confirming casualties and infection.
Antananarivo is 200 kilometres east of Soamahataman village in Tsiroanomandidy district -- the epicentre of the disease.
The first case, a man identified in late August, died four days later.
This Antananarivo woman is worried by the World Health Organisation's warning the plague could spread rapidly through the city.
(Translated)"The basic hospital in Madagascar can not take care of cases of serious illnesses, because they do not have facilities. They do not have even medicine to deal with small cases."
The WHO warns resistance among the population to an insecticide used against fleas is causing further complications.
But Sir Richard Feacham is confident that Madagascar's plague epidemic can be contained early on, unlike Ebola.
"It has been identified. It will be a challenge in that country, but it will be contained. And I think it's unlikely that we will see much geographic spread of the bubonic plague. Ebola is a different story. We woke up to Ebola far too late. We, the international community, are now doing much more and the scale of the response is approaching what is desirable and necessary, but it was all highly delayed and many months passed without the nature of the risk being recognised at all, or fully recognised."
