In 2014, there was an outbreak of the plague (yes, the plague that killed millions in the dark ages) in Madagascar. 263 cases were documented, and 71 people died from it. The WHO evaluated plague as having a high risk of becoming an epidemic given that it is highly contagious via coughing, and that urban places in Madagascar are densely packed. The country's weak healthcare system would adds to this risk. The plague is also spread via fleas, which are particularly rampant after rainy seasons. The fleas are becoming resistant to the insecticides typically used against them. Apparently plague outbreaks have resurfaced every few years since 1980, and Madagascar is the country most severely affected by the plague in the world.
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