Should we be afraid of the return of the plague in France and in Europe ?

Health 8 January, 2018

Published the 07.01.2018 to 19h32


Keywords :

pesteMadagascarrésurgencebuboniqueforme pulmonary

The recent outbreak of plague that blazed in Madagascar has been a concern for the specialists because it has been very unusual.
Unusual, first, by its magnitude : each year, more than 300 cases of plague are reported in Madagascar during the epidemic season, which runs from September to April. But this year, it is 2 348 Madagascar were infected by the bacterium Yersinia pestis, and among them, 202 have succumbed to the disease.
Other atypia, in contrast to previous years, three-quarters of the patients were this year with the pulmonary form of plague, which is considerably more contagious, more serious, and more deadly than the form bubonic plague.
Finally, the epidemic 2017 of plague in Madagascar has been almost general, and it has affected also the major cities, including the capital, Antananarivo, while it was only the rural areas in the other years.

The plague of Madagascar does it spread ? Y a-t-he other case today in other countries ?

JFL : The latest data from the WHO show that this terrible disease does not belong to the past. Each year in the world, approximately 600 people are affected. According to the latest figures from the World Health Organization, from 2010 to 2015, we recorded 3248 cases of plague in the world, including 584 deaths.
After the implementation of drastic measures (with the support of the WHO), the malagasy government has officially declared the 27 November ” the end of the epidemic of pneumonic plague urban “, but the surveillance must continue.

This is not like smallpox, which has been completely wiped off the map ?

JFL : yes, Indeed, smallpox has been eradicated thanks to vaccination, but the cholera, and polio are still there, and as to these diseases, cases of plague appear especially in places unhealthy, and associated with a great misery. Today, it is in Africa, for example in Peru, the democratic Republic of the Congo, and also Madagascar that the illness strikes the most.
But several developed countries such as the United States or Russia, regularly report new outbreaks of the plague. This is related to the existence of a wild animal (a different species of rodent, depending on the country) which serves as the reservoir for the disease

Is this mean that the plague is at the gates of Europe ?

JFL : at present, Europe is spared, but it is not completely safe because the plague reappears in countries where it had disappeared completely, sometimes for over 80 years. For example, it is returned to Algeria, where there had not been since the famous plague described by Camus in Oran (who succeeded to that of Algiers) (1944-45). Ditto in Jordan. With the multiplication of hotbeds of war and the massive transfers of populations, the plague could reappear on a large scale, including in France.

Is it that you risk something in France ?

JFL : The last major epidemic in France date from 3 centuries ago ! Between 1720 and 1723, an epidemic of plague at Marseilles and its region had done nearly 120,000 dead on the 400 000 inhabitants of the region had at this time !
But the last case French is not buried in the history in france since it is located in Corsica in 1945. Therefore, the risk of a resurgence of the plague is absolutely not excluded.
In addition, when one sees the proliferation of rats in Paris, one said that it should not be the great thing for this to go back

How do you explain this re-emergence of the pneumonic in Madagascar ?

JFL : one explanation could be the decrease of the vigilance of the health authorities over the years. As a country knows itself to be infected by the plague, many surveillance measures are put in place and the antibiotic treatment put in place ? With these precautions, the epidemic does not. But as the cases become rare, some countries let their guard down.
It also discusses the global warming. Several studies have shown that changes in temperature could promote the development of the animal reservoir and its expansion, or even a change of virulence of the bacteria, which are becoming more aggressive.

This animal reservoir, as you say, these are the rats ? The plague still remains associated with the misery ?

JFL : And a bacterium ! Yersinia Pestis, the name of its discoverer Alexandre Yersin. This bacteria often lives in the blood of mammals, including rats and animals related parties, which are the reservoir where there is still the bacteria. But it needed a vector to transfer bacteria to man. This vector is a flea that has sucked the tainted blood of the rodent and can transfer the bacteria to Humans if it comes too close to rats.
In cases of recurrence of the plague, come to damage health major (wars), the great human migration and international trade. They could help the bacteria to end up in the West.

What are the symptoms of the plague ?

JFL : The first symptoms of the plague appear more or less quickly, from a few hours to five days after the contamination.
The bubonic plague is the form of the disease is the most frequent (80% to 93%). It is manifested by high fever, poor general condition and an increase in volume of the lymph node that drains the area of the sting of the chip. The lymph node enlarged and painful, is called a ” bubo “. It may suppurate, and then heal.
In the case of pulmonary form of plague, the disease starts as a pneumonia particularly severe (fever, cough, pain in the chest), which is evolving very, very rapidly to sepsis, which is a generalized infection, fatal in a few days… and very contagious. This is what happened in Madagascar.

Is it that you have a treatment?

JFL : Yes, fortunately, the plague bacillus is always susceptible to antibiotics, which helped with hygiene measures not to have these terrible waves of epidemic. But it is necessary to have access to these drugs, which is not always the case in some regions. Hence the persistence of foci.

The ideal solution lies in the vaccine ?

JFL : Several vaccines against plague have been developed over the years, but they have serious side effects. In addition, they have no effect on the pneumonic plague.
A team from the Institut Pasteur has already obtained very promising results on a vaccine potential, but due to lack of funding, it is impossible for the time being to test it in humans. The industrialists are not interested in this market of the plague which continues to be weak, I must admit.

In conclusion, do not panic, the plague has not disappeared, for all that, a plague epidemic is not for tomorrow.