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#621
Madagascar
Keymaster

The year 1969, in the Bulletin of Madagascar of April, then of June and July, and finally of August, the archivist paleographer Jean Valette publishes an important work on “The Mission Lesage with Radama I 1816-1817” With the edition of the newspapers of Lesage and Doderlein. It also accompanies many comments and notes.
According to E. R. Brygoo, the “Medical comments on a trip to Antananarivo in 1817” are of particular interest to the epidemiologist. Indeed, the death by illness, in less than four months, between December 23, 1816 and April 10, 1817, of fifteen of the forty-one adult Europeans is a very heavy balance. They are eight civilian officers, three other members and about thirty soldiers of Captain Lesage in Antananarivo. According to Brygoo, there is no doubt as to the etiology of the malaria, nor the origin of the contamination. Most of the subjects are infested shortly after their landing and probably during their stay in Toamasina. Excerpts.
“The climate of Antananarivo passes for very unhealthy from the middle of November to the beginning of March; And even during the rest of the year, it can not be considered good. Whites generally have a yellow and bilious complexion. “The fever begins with a shudder from abundant sweat, and then, almost suddenly, one is seized with an icy cold. The description of the access is precise.
The incubation period is silent. The troop is in good health and, as of the date
12 December, Lesage can write: “Yet no one had yet suffered in his health nor groaned from deprivation of food. The only thing we could complain about was the inclemency of the season and our great tiredness. Tiredness, Brygoo believes, is certainly an aggravating factor. The first, Young falls ill on December 16, less than a month after landing in Toamasina on November 18. The duration of the minimum malaria incubation is two weeks. The form of the disease in Young, rapidly fatal (death on December 23, in six days) corresponds to “a pernicious malaria of first invasion”.
The simultaneous or almost simultaneous explosion of the cases is, moreover, in favor of a massive contamination either in Toamasina or in the very first days of the journey. Excerpts.
December 23: “M. Bidard, still very ill; Most Indians and soldiers are sick; The bugle and Mr. Young are both in a worrying state as well as most of the mission members. “
The clinical form presented by some is typical of the “third form”. For Hector, Lesage writes: December 22, “… (he) was almost shivering in his turn since I returned from the king.” On 23 December, “Hector had recovered himself this morning.” On 24 December, “… Hector had a relapse at the same time.”
For Lesage, on the 23rd of December, “after breakfast I was seized with my fever, Cephalgia, eye pains.” On December 24, “I was much better this morning.” On 26 December,
“On the evening of the 24th, I had a relapse and was very ill all night.”
Lesage, moreover, says: “The disease manifested itself in all, as I have been told, in the same manner with ups and downs, as in intermittent fever, accompanied by more or less delirium. He also mentions: “I took quinine all the time. It is doubtless why, although severely affected, he can escape from it.

The second wave of mortality (12 March-10 April) is manifested after the return to the East Coast, giving everyone the opportunity of a “particularly serious re-infestation for already debilitated organizations”. The detachment is back in Toamasina on 27 February. They have been in Andevoranto since the 22nd and, instead of embarking immediately, are awaiting on the spot an improvement of their state of health, exposing themselves thus again to the contamination.
The heavy balance of the expedition, of which more than one member out of three died of malaria, is undoubtedly not foreign to the sinister reputation that must later have the tracking East-Antananarivo. A. Le Roy de Méricourt wrote in 1870 (“Encyclopedic Dictionary of Medical Sciences”, article on Madagascar): “However, very few days of walking in this city (Antananarivo) we find very unhealthy localities such as Valley of Beforona, one of the most formidable points of Madagascar, which was the place of detention of the illustrious traveler Ida Pfeiffer and which must be crossed to go, from Tamatave to Emyrne. The Hovas of the interior, themselves, who go to the coast, are often victims either by crossing the forests or shortly after their arrival on the coasts of the effluvia against which they do not enjoy a greater Immunity than Europeans. “
Brygoo wonders if the sanitary failure of this expedition which follows the shorter path of the eastern forest is not one of the causes of the choice of the western route for the conquest of Antananarivo in 1895. However, because of the numbers, this is “a real hecatomb, 6,700 deaths, a health disaster”, according to Jean Lemure, of which 72% of deaths are due to malaria.