The World Health Organisation (WHO) has told South Africa and eight other countries to prepare for an outbreak of the Black Death (plague), which has currently infected more than 1,000 people in the island nation.

In the WHO’s latest update on the outbreak, the body said: “Nine countries and overseas territories have been identified as priority countries in the African region for plague preparedness and readiness by virtue of having trade and travel links to Madagascar.”

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If the plague were to spread to South Africa, or Mauritius, Seychelles, Tanzania, La Réunion, Mozambique, Kenya, Ethiopia or the Comoros, it would potentially devastate the Southern African region’s cruise industry.

When the Ebola crisis erupted in 2014, dozens of cruise lines with scheduled port calls in West Africa pulled their itineraries, and most have yet to return to former ‘off the beaten track’ port destinations such as Monrovia, Freetown and Conakry.

A total of 1,133 people have been infected across the country, with the risk of further spread of the disease “very high” according to latest WHO analysis.

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Unicef, the Red Cross, the Centers for Disease Control and Prevention (CDC) and the European Centre for Disease Prevention and Control (ECDC) have mobilised emergency plans in the countries.

The plague has a 30 to 100 per cent chance of death if left untreated, making it just slightly less dangerous the Ebola, which kills 50% to 100% of patients.

There are a total of 46 cruise ship calls scheduled for various Madagascan ports, the vast majority sailing roundtrip out of Mauritius and Reunion and visiting Madagascar as part of a 14-night Indian Ocean cruise aboard Costa Cruises neoRiviera.

Other cruise lines visiting Madagascar this year include AIDA, Fred Olsen, Oceania Cruises, Silversea, and Phoenix Reisen. Cruise Arabia & Africa has reached out to them for comment.

So far, Fred Olsen Cruise Lines has confirmed that Boudicca’s scheduled November port call in Tamatave, Madagascar has been cancelled. A decision regarding the remainder of the Indian Ocean fly-cruise season will be taken imminently, the cruise line said.