Madagascar might need millions more in aid to combat plague outbreak


The World Health Organization says it needs more money to help fight a plague outbreak in Madagascar.

The organization has sent roughly 1.2 million doses of antibiotics to the island and released $1.5 million in emergency funds to help combat the outbreak. 

The small African island isn't a stranger to the plague; a few hundred cases are typically reported every year, mostly between September and April.

This year, though, the country's health minister has already reported 387 cases of the plague and 45 deaths.

More on the outbreak in Madagascar: 

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Plague outbreak ravages Madagascar
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Plague outbreak ravages Madagascar
A council worker sprays disinfectant during the clean-up of the market of Anosibe in the Anosibe district, one of the most unsalubrious district of Antananarivo on October 10, 2017. The World Health Organization has warned that a deadly outbreak of the plague, which began in late August, has claimed more than 20 lives in Madagascar and is swiftly spreading in cities across the country. Rats are porters of fleas which spread the bubonic plague and are attracted by garbages and unsalubrity. Pneumonic plague, which is passed through person-to-person transmission, has also been recorded. / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
People walk past a full dumpster as Council workers begin the clean-up of the market of Anosibe in the Anosibe district, one of the most unsalubrious districts of Antananarivo on October 10, 2017. The World Health Organization has warned that a deadly outbreak of the plague, which began in late August, has claimed more than 20 lives in Madagascar and is swiftly spreading in cities across the country. Rats are porters of fleas which spread the bubonic plague and are attracted by garbages and unsalubrity. Pneumonic plague, which is passed through person-to-person transmission, has also been recorded. / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
People clear garbage during the clean-up of the market of Anosibe in the Anosibe district, one of the most unsalubrious districts of Antananarivo on October 10, 2017. The World Health Organization has warned that a deadly outbreak of the plague, which began in late August, has claimed more than 20 lives in Madagascar and is swiftly spreading in cities across the country. Rats are porters of fleas which spread the bubonic plague and are attracted by garbages and unsalubrity. Pneumonic plague, which is passed through person-to-person transmission, has also been recorded. / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
A boy covers his mouth as a council worker sprays disinfectant during the clean-up of the market of Anosibe in the Anosibe district, one of the most unsalubrious districts of Antananarivo on October 10, 2017. The World Health Organization has warned that a deadly outbreak of the plague, which began in late August, has claimed more than 20 lives in Madagascar and is swiftly spreading in cities across the country. Rats are porters of fleas which spread the bubonic plague and are attracted by garbages and unsalubrity. Pneumonic plague, which is passed through person-to-person transmission, has also been recorded. / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
A pedestrian passes a Ministry of Health and Malagasy Red Cross healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
A young woman (L) gestures as she is examined by a doctors at a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
Doctors and nurses from The Ministry of Health and officers of the Malagasy Red Cross staff a healthcare checkpoint at the 'taxi-brousse' station of Ampasapito district in Antananarivo on October 5, 2017, with the mission of informing passengers leaving Antananarivo, and to potentially detect cases suspected of plague. Madagascan authorities have ordered two universities to close temporarily as efforts intensify to halt a plague outbreak that has killed 33 people and caused widespread panic. The Indian Ocean island nation suffers annual plague outbreaks, but this year the disease has affected urban areas, triggering concern from the World Health Organization (WHO). / AFP PHOTO / RIJASOLO (Photo credit should read RIJASOLO/AFP/Getty Images)
ANTANANARIVO, MADAGASCAR - OCTOBER 03 : Workers from Department of Emergency and Response to Epidemics and Disasters (SURECA) within the Ministry of Health of Madagascar implement a desinsectisation in a public school in Antananarivo, Madagascar as plague spreads rapidly in cities across the country on October 3, 2017. Twenty people have died so far from plague in Madagascar while more than 100 other suspected cases have been registered across the country. (Photo by Henitsoa Rafalia/Anadolu Agency/Getty Images)
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That's partially due to the type of plague involved in the outbreak.

The more common — and more commonly known — bubonic plague, which was responsible for the "Black Death" in medieval Europe, is passed to humans from fleas. Fleas pick up the plague-causing bacteria Yersinia pestis from small mammals like rodents.

But health officials are predominantly reporting cases of pneumonic plague, which can be spread from person to person through coughing. This kind of plague is far more deadly. While bubonic plague kills 30 to 60 percent of infected people, pneumonic plague is always fatal without treatment.

Madagascar is also a very poor country, and that's contributed to the outbreak. People living in poor, rural areas come into contact with rodents and their fleas more often. And health care options are few and far between, making it even harder for people to find affordable treatment after becoming infected.

The WHO has appealed for another $5.5 million "to effectively respond to the outbreak and save lives."

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