An outbreak of bubonic plague has killed 40 people and infected over 100 others in Madagascar, the World Health Organization (WHO) has announced.
The data was recorded between August when the first known case in the outbreak was announced and mid-November, according to the WHO report.
The situation is worsened by high levels of resistance among fleas to a leading insecticide, population density and poor sanitation, the WHO added.
The disease is transmitted by fleas, which often reside in the hair of rats and other rodents.
The most infamous symptom of bubonic plague is an infection of the lymph glands (lymphadenitis), known as buboes, which become swollen and painful.
Within 3 to 7 days of exposure to plague bacteria, Y. pestis, the bacteria becomes localized in an inflamed lymph node and the flu-like symptoms such as fever, headache, chills and weakness appear in the infected person.