The United Nations World Health Organization has rushed millions of doses of antibiotics of Madagascar to fight an outbreak of plague.

The island nation off Africa's east coast normally charts about 400 cases of plague every year.  But the health ministry says the latest bout of plague has killed 33 people and infected about 230 more.

This year's cases are mostly pneumonic plague, which is a severe lung infection and spreads the Yersinia Pestis bacteria through coughing.  It's the most deadly form of the disease and can be fatal within 24 hours.  Bubonic plague and Septisemic plague are spread by fleas that feed on infected rats and then bite humans. 

"Plague is curable if detected in time. Our teams are working to ensure that everyone at risk has access to protection and treatment. The faster we move, the more lives we save," said WHO Madagascar Representative Charlotte Ndiaye in a statement.

But catching cases early is difficult in a poor country with a weak health care system.  And unlike past years, the plague is spreading in Madgascar's urban areas with denser populations.  Prime Minister Olivier Mahafaly Solonandrasana announced that all public gatherings would be banned in the capital Antananarivo to prevent the spread of the disease.