(CNN)The plague outbreak in Madagascar is continuing to spread at unprecedented rates, with 57 deaths and more than 680 cases.
The latest figures are from October 12. An estimated 329 of these cases, and 25 deaths, were in the capital, Antananarivo.
Cases - World - Health - Organization - WHO
The cases, reported by both the World Health Organization (WHO) and the National Bureau for Risk and Disaster Management (BNGRC) in Madagascar, include probable and suspected cases as well those that have been confirmed by laboratory tests.
While the country experiences regular outbreaks, with an estimated 400 cases of plague each year, this time things are very different, experts warn.
Year - Health - Officials - Infections - Areas
This year, health officials report the infections started much earlier than usual, and they're occurring in new areas, including urban settings. They've also seen an unexpected number of cases of pneumonic plague, which transmits more easily from person to person.
Of the 684 cases reported as of October 12, 474 were pneumonic plague, 156 bubonic and 1 septicemic plague. A further 54 were unspecified, according to WHO.
Madagascar - Districts - Cases - Plague - Cities
Of Madagascar's 114 districts, 35 have reported cases of plague, including at least 10 cities.
Council workers clear garbage during the clean-up of the market of Anosibe in Antananarivo. Rats are porters of fleas which spread the bubonic plague and are attracted by garbages and unsalubrity.
Plague - Infection - Bacterium - Yersinia - Pestis
Plague is caused by infection with the bacterium Yersinia pestis and is typically spread through the bite of infected fleas, frequently carried by rats, causing bubonic plague. Symptoms include painful, swollen lymph nodes, called bubos, as well as fever, chills and coughing.
Pneumonic plague is more virulent or damaging and is an advanced form characterized by a severe lung infection. The infection can be transmitted from person to person via airborne droplets -- coughing or sneezing. The incubation period is short, and an infected person may die within 12 to 24 hours.
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