The Black Death is killing people: Why is Madagascar facing its worst plague outbreak in years?

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.