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    Q&A: Why Madagascar is facing its worst plague outbreak in years

    by Robyn Dixon, Los Angeles Times Oct 13, 2017 4 minutes

    JOHANNESBURG - Madagascar sees cases of plague nearly every year in the rainy season.

    This year is different. Instead of cases in the hinterlands where plague is endemic, the disease - which is initially spread by flea bites and was known as the Black Death in medieval times - has spread to the capital, Antananarivo, and other densely populated cities for the first time, killing 45 people and sparking panic.

    By Monday, 387 cases had been reported, including 167 in the densely populated capital.

    The biggest problem for authorities trying to control the outbreak is that it took two weeks after the first case to detect it, and

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