There are three types of plague: bubonic, septicemic and pneumonic. Madagascar is experiencing a pneumonic plague outbreak and over 1000 people have recently been infected  by the bacterium Yersina pestis.

This form of plague has 3 characteristics: victims contract a severe lung infection; treatment is with antibiotics; and the mortality rate, if untreated, is high.

Given the prevalence of counterfeit antibiotics in Madagascar, the use of cheap but crowded  transport and the growing rat population because of poor sanitary conditions, it is likely that the plague could reach epidemic proportions by the Christmas holidays when many travel from the Highlands to the coastal regions.

However, cases of the plague have now been reported in another 9 African countries. Many of these countries are holiday destinations for tourists from the Northern hemisphere chasing the sun. South Africa has been identified as one of the priority countries that could be affected, along with Kenya, Mauritius, Tanzania,Ethiopia and Seychelles.

Apart from the danger of spreading the plague by infected air travellers over the holiday season, there is another recently identified threat of far greater concern- bioterrorism.

Last April, Bill Gates warned the Royal United Services Institute in London that an outbreak of the plague or smallpox could spread and kill more than 30 million people in less than a year. The Nuffield Council of Bioethics supported Gate’s claim by reporting that a new technique called Crispr was easily available online. This technique allows ” garage scientists” to cut and paste genetic code for their own use.

But, if that sounds too complicated, security experts have observed that terrorists now have access to over 10 diseases that can be aerosolised. One or two small  cans discharged in a plane before take- off could infect all the passengers before the plane reached cruising altitude.

This might add a sinister dimension to the phrase ” spray and pray”, as used by terrorists who randomly fire machine guns into crowded venues.