- The plague is spreading in densely populated slums in the capital of Antananarivo
- Pneumonic plague is more dangerous than bubonic plague and can be transmitted through coughing
(CNN)An outbreak of the plague has killed dozens in Madagascar, and experts fear those numbers could go up.
At least 119 cases were confirmed by late last year, including 40 deaths, the World Health Organization said in a statement.
And the disease is taking an alarming turn.
"The outbreak that started last November has some disturbing dimensions," the WHO said this week. "The fleas that transmit this ancient disease from rats to humans have developed resistance to the first-line insecticide."
It's especially spreading in densely populated slums in the capital of Antananarivo.
Cases were confirmed in at least 20 districts and the capital, Christophe Rogier of the Institut Pasteur de Madagascar said late last year. Rogier is part of a team working with the WHO on the ground to combat the disease.
Rodents and rains
The plague is caused by Yersinia pestis, a bacteria found in rodents and spread by fleas.
Recent flooding in the nation has displaced tens of thousands of people and an "untold numbers of rats," leading to fears the disease could spread, said Margaret Chan, director-general of the World Health Organization.