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The outbreak is considered a much bigger threat to the region than in previous years because it has taken on its pneumonic form - meaning it is airborne and spread by sneezing and coughing. And experts say the epidemic could still worsen as the death tolls hits 124 and more than 1,300 are left infected.
The medieval disease famously wiped out ONE THIRD of Europe's population in the 13th and 14th centuries in one of the most devastating pandemics in human history known as the Black Death.
Dr Ashok Chopra, a professor of microbiology and immunology at the University of Texas, told The Sun Online the crisis in Madagascar had yet to peak.
He warned it was possible for the deadly plague to move further into the region given the regular flights going in and out of the country. "If they are traveling shorter distances and they're still in the incubation period, and they have the pneumonic (form) then they could spread it to other places. We don't want to have a situation where the disease spreads so fast it sort of gets out of control."
He added: "Most of the cases in the past have been of the bubonic plague but if you look at this particular outbreak, 70 percent of the cases are pneumonic plague, which is the most deadly form of the disease. If the treatment is not given in a very short period of time these people will end up dying."
Plague symptoms include sudden fevers, head and body aches, vomiting and nausea. [see below]
Dr Chopra added that it spreads "very rapidly", as seen by the number of cases in Madagascar doubling within a week.
Speaking from Madagascar, Christine South, head of IFRC's emergency operations, said: "With anything like this there is a possibility that somebody could be infected and get on a plane. We have done preparedness support to some of the neighbouring countries." However, she added that she believed the plague outbreak may now be stabilising but medical staff would have a clearer understanding of this over the next few days.
According to the World Health Organisation, the disease - which has struck heavily populated cities - sparked a false alarm in the Seychelles after a traveller reported symptoms of the disease.
WHO stated: "The risk of regional spread is moderate due to the occurrence of frequent travel by air and sea to neighbouring Indian Ocean islands and other southern and east African countries. Nine countries and overseas territories have been identified as priority countries in the African region for plague preparedness and readiness by virtue of having trade and travel links to Madagascar.
WHAT IS THE PLAGUE?
Plague is an infectious disease caused by bacteria usually found in small mammals and their fleas.
It has an extremely high fatality rate and is very infectious, although it can be treated by antibiotics if it's caught early.
There are three forms of plague infection: pneumoic plague, septicaemic plague and bubonic plague, the most common form.
Bubonic plague was known as the Black Death in medieval Europe, where an outbreak brought entire civilisations to their knees and decimated the world's population.
Black Death is spread through the bite of infected fleas, whereas pneumonic plague, the most contagious form, develops after a bubonic infection.
Pneumonic infections can then be spread through the air, while septicaemic plague occurs when infection spreads through the bloodstream.
The three different types of plague all refer to different ways the disease can be spread.
In bubonic infections, plague-causing bacteria can be transmitted between animals and fleas, with infected fleas then passing the disease on to people through bites.
Infected people may then develop pneumonic plague once their bubonic infection becomes advanced.
Lung-based pneumonic plague can then sometimes be transmitted through the air between sufferers.
Following a pneumonic or bubonic infection, people can then develop septicaemic plague, which occurs when the infection spreads through the bloodstream.
The World Health Organisation describes plague symptoms as "flu like", with one to seven days between incubation and the symptoms emerging.
Sufferers are likely to have painful lymph nodes, chills, fever, headaches, weakness and fatigue.
In bubonic sufferers, these inflamed lymph nodes may end up turning into pus-filled open sores.
Bubonic plague is fatal in 30-60 per cent of cases, while the pneumonic kind is always fatal, if left untreated.
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