A plague in Madagascar has left 57 dead as of Thursday, Oct. 12. Over 680 documented cases have been reported, which is an unusually high number this early in the plague season.

According to reports, 329 of those cases, including 25 deaths, occurred in Antananarivo, the capital of Madagascar.

The plague outbreak could spread even further. But here's what's even more worrying: The form of the disease that's spreading, pneumonic plague, is known to be the deadliest. The outbreak is on a larger scale and is escalating far more rapidly than a plague typically does.

A Plague Outbreak Is Killing People In Madagascar

The cases, as reported by the World Health Organization and the National Bureau for Risk and Disaster Management, include possible and suspected cases in addition to those that have since been confirmed through laboratory tests, CNN notes. It's worth mentioning that Madagascar does go through regular outbreaks, with 400 cases annually, based on estimates. But things are particularly more alarming this time, experts suggest.

Infections started earlier than expected this year, according to health officials, and they're reaching new areas, including the more urban parts of the country. At least 35 districts were hit with plague cases, including 10 cities.

There were 474 cases of pneumonic plague, 156 of bubonic plague, and a single case of septicemic plague as of Oct. 12.

As Business Insider reports, plagues can be treated with antibiotics if caught early enough. The WHO announced on Oct. 6 that it had delivered 1.2 million doses of antibiotics to the country and greenlit $1.5 million to help stop the disease. But the outbreak is still rapidly spreading despite such efforts.

Why There Are Plague Outbreaks In Madagascar

Why do outbreaks occur in Madagascar? Well, a type of bacteria called Yersinia pestis, which causes the three aforementioned plagues, is regularly found in certain locations around Madagascar. The United States sees a few plague cases each year; Madagascar, by contrast, sees about 400 in the same period.

The typical plague season begins in September then continues up until April, but in the first six weeks, there have already been more than 680 documented cases, as mentioned. This is alarmingly unusual for Madagascar, since according to Daniel Bausch of the UK Public Health Rapid Support Team, there are usually only 200 cases after the first six months.

The unusually high number could be due to the form of the plague. Unlike bubonic and septicemic plagues, a pneumonic plague works by spreading from person to person through airborne droplets — either by coughing or sneezing. It is 100 percent fatal, and a person infected with it may die within 12 to 14 hours.

How Madagascar And The WHO Are Dealing With The Outbreak

The country has closed some schools and prohibited large public gatherings in affected cities, according to reports. The WHO has already sent enough medicine to treat 5,000 residents. But the organization is still seeking $5.5 million to aid local workers in diagnosing the plague, treating those who have been infected, and determining how it's spreading by tracing the contacts of infected individuals.

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