Antananarivo, Dec 12 (IANS): At least 20 people have been killed by bubonic plague, once feared as the 'Black Death', in Madagascar, a leading British daily reported.

The rodent-borne disease was responsible for the deaths last week near the north-western city of Mandritsara, The Guardian quoted health experts as saying Wednesday.

The Pasteur Institute of Madagascar has said that tests taken from bodies in the village last week showed that they had died of bubonic plague.

The experts from the institute added that the disease could spread to towns and cities where living standards have declined since a coup in 2009.

The International Committee of the Red Cross (ICRC) had warned the island nation of the risk of a plague epidemic.

Bubonic plague, which has disappeared from Europe and large parts of the globe, is spread by bites from plague-carrying rat fleas - Xenopsylla cheopis - whose main host is the black rat.

In Europe the threat of the Black Death pandemic, which appeared with black rats brought by merchant ships from Asia, eventually died out as black rats were displaced by brown rats and health and hygiene improved.