Move over cholera, here’s the Black Death

The Black Death, caused by the bacterium Yersinia pestis, wiped out 30 to 50 percent of Europe’s population between 1347 and 1351

Now, South Africa has been placed on high alert for a potential plague infection.

Mortality rates are estimated anywhere between 30% and 100% without treatment. Many estimates are towards the top end of this range, 80% to 95%. Treatments are available (mostly antibiotics) and are generally effective. Mortality rate where adequate treatment is administered within 24 hours can be 11%.  (Either “just 11%” or “11%!” depending on whether you’re counting up from 0% or down from 95%.)

Spread of Black Death across Europe in 14th century
Spread of Black Death across Europe in 14th century

Plague in Madagascar

124 people have already been killed by the plague in Madagascar. But this is just a particularly bad year.

Every year for the last nearly 40 years, Madagascar has a seasonable outbreak of plague. This is good news in that treatment of the disease and management of its spread is well understood.

Spread of Plague

Bubonic plague, which is more common, is spread mostly by flea bites and is not particularly contagious between humans. However, it can be transmitted between humans and when it infects the lungs to become pneumonic plague, it is far more infectious.

The good news is that it probably isn’t really a major threat even with impaired sanitation in Cape Town likely from water shortages.

What about Cholera?

Despite my concerns about cholera arising out of our water crisis, it is worth noting that the 2008-2009 outbreak in Zimbabwe claimed under 5,000 lives. As tragic as each of those deaths is, it is not the hundreds thousands or millions experienced in centuries past.

From a societal perspective, these levels of pandemics are very serious. The impact on the insured population, especially when weighted by sums assured and death claims, is still likely very low. (Although catastrophe reinsurance will not cover these days. QS and Surplus are the key lines of defence here from a reinsurance perspective.)


(If you like the idea of working tirelessly to rid the word of pandemics, check out Pandemic Board Game. If you lean more evil mastermind direction, Plague is a game where the goal is to infect the entire world.)

Published by David Kirk

The opinions expressed on this site are those of the author and other commenters and are not necessarily those of his employer or any other organisation. David Kirk runs Milliman’s actuarial consulting practice in Africa. He is an actuary and is the creator of New Business Margin on Revenue. He specialises in risk and capital management, regulatory change and insurance strategy . He also has extensive experience in embedded value reporting, insurance-related IFRS and share option valuation.

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