Fearsome airborne plague epidemic strikes Madagascar

Madagascar typically has about 400 cases of plague each year between September and April, but they are usually focused in the nation’s central highlands and spread by fleas living on rats in rice-growing areas. This outbreak is unusually worrying because most new cases are in cities and are pneumonic plague, the form transmitted by coughing.

Pneumonic plague kills even faster than the better-known bubonic form, which is transmitted by flea bites and gets its name from the infected lymph nodes that form large, swollen “buboes” in the groin, armpits and neck.

Both forms caused the infamous Black Death of the mid-14th century, which is thought to have killed a third of Europe and caused major social upheavals.