The Bubonic Plague is resurfacing in Madagascar and has claimed the lives of 47 people.

Madagascar is working to contain the outbreak, but concerns are arising from the U.N. that the disease is being caused by a insecticide-resistant flea. It’s a fairly easy disease to treat, but it’s incredibly contagious through coughing, and if it reaches the lungs to become pneumonic plague, it can kill within 24 hours.

Health Minister Philemon Tafangy has announced that “antibiotics have been given to all those who had come in contact with the infected.”

The disease is spreading throughout the slums of the capital of Antananarivo.

A woman whose daughter died from the plague blames the filth of the slums, which becomes a haven for rats that carry the fleas with the plague.

“Our neighborhood is really dirty and has been neglected by the state for a long time,” she said.

There have been 138 cases of plague reported in Madagascar.

The World Health Organization and the Red Cross are working with the nation to help eradicate the disease as rapidly as possible.

Historically, the plague wiped out a third of the human population in the Middle Ages. Symptoms of the disease include a swelling of the lymph nodes and other glands to form a bubo, which is something like a large boil.

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