Patients infected with the plague in Madagascar are escaping from hospital because they are afraid of NEEDLES sparking fears disease could spread across ten African countries

  • Security guards at The Central Anti-Plague Hospital Ambohimindra have been stopping patients from escaping after at least one ran away in October
  • Unicef's deputy representative said some patients are afraid of needles  
  • The World Health Organisation (WHO) revealed the death toll has risen to 171

Patients infected with the plague in Madagascar are escaping from hospital because they are afraid of needles and not used to hospitals, prompting fears the disease could spread.

Security guards at The Central Anti-Plague Hospital Ambohimindra in the island's capital Antananarivo have been stopping patients from running away after at least one escaped in October before being forced back into an ambulance.

According to deputy representative of Unicef Jean Benoit Manhes, some patients are scared of needles.

Scientists are growing increasingly concerned this year's outbreak has reached 'crisis' point

International agencies have so far sent more than one million doses of antibiotics to Madagascar. Nearly 20,000 respiratory masks have also been donated

'People here are not used to the hospital,' he told the Irish Times. 'The problem of plague is not just a medical response. You can have hospitals but if people don't come it isn't enough.'

For each person who is infected with the deadly disease, up to 20 people they have been in contact with must also be treated. 

The news comes as the World Health Organisation (WHO) revealed the death toll has risen to 171.

The data also shows the 'medieval disease' has infected 2,119 in the country off the coast of Africa - a four per cent jump in a handful of days. 

In Madagascar, a sacred ritual sees families exhume the remains of dead relatives, rewrap them in fresh cloth and dance with the corpses

HOW THE PLAGUE HAS ESCALATED

DATE OF REPORT

October 4

October 9

October 12

October 17

October 20

October 26

October 31

November 6

November 9 

November 14 

INFECTED/DEAD

194/30

387/45

684/57

849/67

1,297/102

1,309/93

1,801/127

1,947/143

2,034/165 

2,119/171 

The 'crisis' has prompted ten African countries to be placed on high alert, with the WHO ordering nine to step up preparations.

Experts fear the plague, which strikes Madagascar every year, will inevitably become resistant to antibiotics and mutate and become untreatable.

Others worry it will eventually hit the US, Europe and Britain, leaving millions more vulnerable due to how quick it can spread through populations.

And with the plague season expected to run until April, scientists believe there will be another spike of cases in the coming months.

Scores of doctors and nurses have already been struck down with the disease, and there are growing fears hospitals will be unable to cope if it continues its rampage. 

Two thirds of cases have been caused by the airborne pneumonic plague, which can be spread through coughing, sneezing or spitting and kill within 24 hours.

It is strikingly different to the bubonic form, responsible for the 'Black Death' in the 14th century, which strikes the country each year and infects around 600 people.

Malawi was added to the growing list of nations placed urged to brace for a potential outbreak over the weekend, becoming the tenth.

Officials in Madagascar have warned residents not to exhume bodies of dead loved ones and dance with them because the bizarre ritual can cause outbreaks of plague 

South Africa, Seychelles, La Reunion, Tanzania, Mauritius, Comoros, Mozambique, Kenya and Ethiopia have already been told to prepare.  

Concerned health officials have warned an ancient ritual, called Famadihana, where relatives dig up the corpses of their loved ones, may be fueling the spread.

To limit the danger of Famadihana, rules enforced at the beginning of the outbreak dictate plague victims cannot be buried in a tomb that can be reopened.

Instead, their remains must be held in an anonymous mausoleum. But the local media has reported several cases of bodies being exhumed covertly.

Despite the serious risks publicised by the authorities, few in Madagascar question the turning ceremonies and dismiss the advice.

Willy Randriamarotia, the Madagascan health ministry's chief of staff, said: 'If a person dies of pneumonic plague and is then interred in a tomb that is subsequently opened for a Famadihana, the bacteria can still be transmitted and contaminate whoever handles the body.'

Experts have long observed that plague season coincides with the period when Famadihana ceremonies are held from July to October.

HOW DID THIS YEAR'S OUTBREAK BEGIN?

Health officials are unsure how this year's outbreak began.

However, some believe it could be caused by the bubonic plague, which is endemic in the remote highlands of Madagascar.

If left untreated, it can lead to the pneumonic form, which is responsible for two thirds of the cases recorded so far in this year's outbreak.

Rats carry the Yersinia pestis bacteria that causes the plague, which is then passed onto their fleas.

Forest fires drive rats towards rural communities, which means residents are at risk of being bitten and infected. Local media reports suggest there has been an increase in the number of blazes in the woodlands.

Without antibiotics, the bubonic strain can spread to the lungs - where it becomes the more virulent pneumonic form.

Pneumonic, which can kill within 24 hours, can then be passed on through coughing, sneezing or spitting. 

However, it can also be treated with antibiotics if caught in time. 

Madagascar sees regular outbreaks of plague, which tend to start in September, with around 600 cases being reported each year on the island. 

However, this year's outbreak has seen it reach the Indian Ocean island's two biggest cities, Antananarivo and Toamasina.

Experts warn the disease spreads quicker in heavily populated areas. 

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