Bubonic plague is carried by fleas found on rats. Photo / Getty Images
Twenty people have died following a deadly outbreak of the bubonic plague, medical experts on the island of Madagascar have confirmed.
Public Health officials had warned of the risk of an outbreak in October.
In 2012, 256 cases of the disease were recorded and 60 people died, making Madagascar the
most severely affected country in the world. The disease is transmitted to humans usually via rat fleas and prisoners typically face the highest risk because of their living conditions.
The International Committee of the Red Cross (ICRC) and the Pasteur Institute had said Madagascar's dirty, overcrowded prisons could be an ideal breeding ground for the disease.
They have been working with local health groups on schemes to improve prison hygiene and reduce rats in a bid to fight the plague at Antanimora Prison in Antananarivo, where 3,000 inmates are held.
