[article] A village in Madagascar has been hit by a deadly outbreak of the bubonic plague, medical experts on the island have confirmed. Test were carried out after at least 20 people in the village, near the north-western town of Mandritsara, were reported to have died last week. The International Committee of the Red Cross warned in October that Madagascar was at risk of a plague epidemic. The disease is transmitted to humans via fleas, usually from rats. What is bubonic plague? Caused by the bacterium Yersinia pestis Essentially a disease of wild rodents, spread by fleas Plague spreads to humans either by the bite of infected fleas or rats Does not spread from person to person Patients develop swollen, tender lymph glands (called buboes) and fever, headache, chills and weakness It is treatable if caught early, but can be lethal Bubonic plague, known as the Black Death when it killed an estimated 25 million people in Europe during the Middle Ages, is now rare.