The World Health Organisation (WHO) has released a major warning as it works to contain a spread of plague from reaching Africa.
The organisation has said more than 1,300 people have become infected with the disease, which is primarily affecting Madasgascar off the coast.
It has spent millions of dollars in efforts to fight the disease and has sent specialists to the affected areas in cities like Antananarivo.
Figures from the WHO state at least 93 people have died, and there was a high risk it could spread to countries on the eastern coast of the continent of Africa, like Tanzania, South Africa and Mozambique.
Some of the cases of plague are reported to be pneumonic, which means it can be transmitted by coughing or sneezing, and is airborne.
It is almost always fatal if left untreated, but if caught early enough, can be eliminated with antibiotics.
The disease is caused by the same type of bacteria which wiped out nearly 50 million people in Europe during the years of the Black Death.