At ground zero, in Mayibuye township near Midrand, it’s business as usual a few days after the National Institute for Communicable Diseases (NICD) trapped a rat there that later tested positive for antibodies for the once-deadly bubonic plague.
The bubonic plague killed 30% to 60% of Europe’s population in the 14th century and had a profound effect on the continent’s history.
The last reported case in South Africa was in Coega in the Eastern Cape more than 30 years ago.
A few weeks ago, the NICD, during their usual testing schedules, found a live rat that tested positive for antibodies of the disease.
“What is that [bubonic plague]?” asked Simon Vimbani from Mayibuye, when interviewed by the Mail & Guardian. That is the puzzled reaction of many residents in the township, where large rats have bitten babies, children and adults.
Another resident, Thembela Nkwanyane, said they had heard the reports of the rat but felt helpless because there is little to no rubbish collection in the area.
“This will show everyone the kind of circumstances we have to live under,” he said. “It will only make sense that there are killer rats here.”
Workers at the Pikitup waste removal company in Johannesburg have been on strike for weeks and garbage has piled up on the streets of the city, its suburbs and townships.
Dr Frank Peters, head of the clinical unit of family medicine at Tembisa Hospital, said doctors regularly treated people from the township who had been bitten by rats.
“The Tembisa area is well known for having rats, but recently we have not had an increase in those cases.”
Peters added that, though they are not alarmed by the report of the Mayibuye rat, they have placed all health practitioners on alert to monitor if anyone is admitted for plague-like symptoms, which include a high fever, headaches and muscle pain.
“We must be aware that it’s not the rats that spread such a disease but the fleas on them,” he said. “Once there is an ulcerated area caused by a rat bite, a flea could infect it.”
Professor John Frean, the deputy director of the NICD, said: “The plague seems to have disappeared for many decades, but keep in mind that the ecology of the plague shows that it’s actually a disease of wild rodents and not those that live with us like mice and rats.”
Occasionally, wild rodents can transfer diseases to rodents that live in urban areas, he said.
One infected rodent is enough to put hospitals’ disease control officials on alert and, since the first rat tested positive in March, more than 70 rodents have subsequently been tested, with negative results.
The Gauteng department of health said it was concerned about the one positive test because the piling up of garbage in the streets poses a serious health risk to residents and has the potential to spread a number of communicable diseases, such as typhoid fever.
“Clinicians around the Mayibuye areas, and indeed all hospitals in the City of Johannesburg, have been warned about the symptoms of the disease and to report immediately to the authorities any suspected case of plague,” the department said.
Infection control practitioners, health practitioners and residents should all be on the alert, it added.
bubonic plague rats National Institute for Communicable Diseases communicable diseases typhoid fever