ANTANANARIVO, Madagascar (December 20, 2013) At least 32 people have died in an outbreak of bubonic plague in the African island state of Madagascar, health officials said.
Some 84 suspected cases of bubonic plague, 60 of them suspected of being pneumonic or pulmonary plague, a more virulent strain of the disease, have been reported in five of the island's 112 districts in the past month.
Last year, Madagascar reported 60 deaths from bubonic plague.
Poor hygiene and declining living standards as a result of a protracted political crisis since a coup in 2009 are the primary causes of the spread of the disease.
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