While Ebola continues to rage in West Africa, an outbreak of another deadly disease is occurring in the African island nation of Madagascar.

An outbreak of bubonic plague in Madagascar has now claimed almost 50 victims and is spreading to the island’s capital, officials warned today.

There have been 138 suspected cases of the disease – similar to the Black Death in medieval Europe – since the start of the year, with the death toll of 47 expected to rise in the coming months.

Two people have been infected in the capital of Antananarivo, one of them dying, and health workers have mounted a pest control campaign through slum areas around the city.

The health ministry said 200 households had been ‘disinfected’ this month, adding that those who had contact with the infected had been given antibiotics in a bid to arrest the spread the disease.

A video glimpse of the situation comes via the UK Daily Mail:

Bubonic plague, the notorious Black Death that wiped out a significant portion of Europe’s population during the Medieval era, is caused by the Yersinia pestis bacteria found in fleas that usually reside on rodents. Patients develop sudden onset of fever, headache, chills, and weakness and one or more swollen, tender and painful lymph nodes (called buboes). The plague now has a mortality rate of just 10%, namely because patients usually recover after treatment with antibiotics.

However, there is much about this particular outbreak that is troubling. The last case of plague in Madagascar’s capital was ten years ago, and while the there are about 500 cases of bubonic plague annually in that nation, it appears that socio-economic conditions in Antananarivo have deteriorated to the point that rat infestation is a problem.

“We have never have seen so many cases in such a short time like now in Madagascar,” [World Health Oganization] spokesman Christian Lindmeier told DW. The organization has dispatched an expert to Antananarivo to assist local authorities contain the situation.

Furthermore, one of the causes cited for this particular outbreak is that deltamethrin, the leading insecticide against fleas, is no longer working. Fleas are not the only pest becoming resistant to insecticides, either. Bedbug infestation is increasing due, in part, to evolving resistance to a class of insecticides called pyrethroids.

Paired with this news are reports about the resistance to antibiotics that certain bacteria are developing. This does not seem to be the situation for plague-causing bacteria…yet. However, drug resistance is of such concern to medical professionals around the world that the World Health Organization and Centers for Disease Control and Prevention called for a coordinated global response halt this development. No doubt, evolution will continue, and only continued research and development will help modern society stay ahead.

And, if all of this news isn’t bad enough, there are reports that ISIS has plans to weaponize bubonic plague:

[ISIS] terrorists in Syria and Iraq have carried out research into the production of biological weapons, compiling a manual of how to make a device and sharing a religious edict that sanctions the use of weapons of mass destruction against civilians.

The computer seized from a Tunisian chemistry student contained a 19-page manual to learn how to turn the bubonic plague into a weapon of war. The text boasts that biological and chemical weapons are a highly effective means of targeting enemy populations, according to the Arab television channel al-Aan, which obtained the computer from a Syria rebel group.

This Thanksgiving, I am going to count my blessings that I have lived as long as I have in an era when the worst a flea could do was annoy my pet. I will also pray that my son’s generation continues to enjoy the same level of public health.