A plague that hit Madagascar has affected 119 people, 40 of whom had already died of the disease. The outbreak started late this past August and has continued to worsen in the African nation. And with no end in sight, the disease is forecast to spread fast in the capital city, according to the World Health Organization (WHO).

Plague is a bacterial disease which is mainly spread from one rodent to another by fleas. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells the lymph node and can be treated with antibiotics, the WHO said.

There have reportedly been two (2) cases and one death in the country's capital Antananarivo, but the figure could jump quickly because of the city's high population density and weakness of the healthcare system, the WHO warned.

"The situation is further complicated by the high level of resistance to deltamethrin (an insecticide used to control fleas) that has been observed in the country," it added.

Once the bacteria from the plague reaches the lungs, the patient develops pneumonia (pneumonic plague), which is transmissible from person to person through infected droplets spread by coughing. It is one of the most deadliest infectious diseases and can kill people within 24 hours. Two percent of the cases reported in Madagascar so far have been pneumonic, WHO explained

According to WHO's records, the first known case of the plague was a man from Soamahatamana village in the district of Tsiroanomandidy, identified on Aug. 31. He died on Sept. 3 and authorities notified the WHO of the outbreak on November 4.

The WHO said it did not recommend any trade or travel restrictions based on the information available about the outbreak.

The health organizations said that the last previously known outbreak of the plague was in Peru in August 2010.