Antananarivo, Nov 25 (IANS/TASS): The toll in the bubonic plague outbreak in Madagascar rose to 47, secretary-general of the health ministry of the island state Philemon Tafangy said Tuesday.

The number of suspected plague cases reached 138. Two lethal plague cases were reported in the country's capital Antananarivo.

The first plague cases were exposed in August. To fight the spread of the disease, authorities have launched a campaign to disinfect residential houses and public buildings, Tafangy said.

The previous plague outbreak was reported on the island in the Indian Ocean 10 years ago. The disease is transmitted by fleas and rats, pulmonary plague spreads in coughing and can kill a person in 24 hours.

In the Middle Ages, around 25 million died of bubonic plague in Europe.

The World Health Organization (WHO) said that from 2004 to 2013 more than 13,000 plague cases, including 896 lethal cases, were reported in 16 countries in Asia, Africa and America.

Africa has the highest incidence rate in the world, accounting for 97.6 percent of overall number of cases.