PRETORIA, November 25. /TASS/. The death toll of the bubonic plague outbreak in Madagascar has risene to 47, Secretary-General of the Health Ministry of the island state Philemon Tafangy said on Tuesday. The number of suspected plague cases reached 138. Two lethal plague cases were reported in Madagascar’s capital Antananarivo.

First plague cases were exposed in August. To fight the spread of the disease local authorities have launched a campaign to disinfect residential houses and public buildings, Tafangy said.

The previous plague outbreak was reported on the island in the Indian Ocean ten years ago. The disease is transmitted by fleas and rats, pulmonary plague spreads in coughing and can kill a person for 24 hours.

In the Middle Ages around 25 million died of bubonic plague in Europe. The World Health Organization said that from 2004 to 2013 more than 13 thousand plague cases, including 896 lethal cases, were reported in 16 countries in Asia, Africa and America. Africa has the highest incidence rate in the world making 97.6% of overall number of cases.

Russian consumer standards agency recommended Russian tourists to refrain from trips on the island where the risk of quick spread of the disease is high due to a high density of population and a low level of health care development.