by Genese Sodikoff
Recent outbreaks of the bubonic plague in Madagascar offer a glimpse into the dynamics of past outbreaks, the Plague of Justinian (sixth to eighth centuries), the Black Death (fourteenth to seventeenth centuries), and current wave of “Third Pandemic” plagues that began in the nineteenth century. Over the past few years, genetic studies of the bacillus, Yersinia pestis, have revealed why the pathogen was so devastating, killing tens of millions over centuries. Yet much about it remains mysterious.
Tracing the plague's dynamics on the ground raises hard-to-solve questions, hard because of the material conditions in countries of Asia and Africa, where most of today's epidemics erupt. Impassible roads, lack of equipment, broken-down communication networks, proximity to rats in homes, and traditional healing and mortuary practices enable the plague to persist and evolve. Antibiotics contain the plague, but these are not always easy to get, nor are the proper dosages always consumed, in poor, remote areas.
I have just returned from a trip to Madagascar, where I visited the site of the August 2015 plague outbreak (14 cases and 10 deaths). I have a lot to learn, but my burning questions concern how long Y. pestis can survive inside a corpse or underground. For medical workers there, answers could help control outbreaks. And if it turns out that the dead are only ephemerally infectious, an overhaul the current policy on burials and funerary rites would be welcome news. The policy is a source of major anxiety for relatives of plague victims, who are prohibited from burying their kin in family tombs for seven years. For most, accumulating enough money to be able to transfer a body over a long distance is an enormous burden, so the seven years may stretch out indefinitely. Those who die of plague in the hospital may not receive the customary funerary rites from their family. All told, plague victims are unable to transform into proper ancestors. They are lost souls.
