Sadly, since my last letter, the plague has continued to spread across Madagascar and according to the British Embassy, as of 24th October there have been one hundred and two deaths and a total of one thousand, two hundred and ninety seven suspected, probable and confirmed cases. The majority of cases are classified as pneumonic and are spread from person to person. Those affected have a very high temperature and risk of death if untreated within twenty four hours. Bubonic plague is less aggressive and is passed on from the infected fleas of dead rats. At present, we have not had a case in Mandritsara, but staff at the hospital are ready and trained to deal with an outbreak if necessary….