Plague is endemic in Madagascar and a seasonal upsurge, predominantly of the bubonic form, usually occurs yearly between September and April.  According to the general secretary of the Madagascar Ministry of Health, between 300 and 600 suspected cases are reported each year, with about 30 cases of pulmonary plague and 10 to 70 deaths.

CDC/Janice Haney Carr [Public domain], via Wikimedia Commons

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