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Pneumonic plague has killed five people in Madagascar since August, a top health official said, but stressed the situation was under control.
"We have detected 22 suspected cases of pneumonic plague, including five deaths," said senior health ministry official Willy Randriamarotia.
"There have been no deaths since Monday," he said, adding that there was widespread panic in the eastern region of Tamatave "which has not seen the plague for 100 years."
Plague killed millions of people across the world in earlier centuries.
The first death in Madagascar's recent outbreak came on August 28 when a passenger in a bush taxi died en route to Tamatave.
Two others who came in contact with the passenger also died, while two more people succumbed to the disease in the province of Antananarivo.
About 300 people have been treated so far for plague, the health ministry said.
There have been outbreaks every year in Madagascar since 1980, especially fuelled by rats fleeing forest fires.
Plague can be cured with antibiotics, but can be fatal within 24 hours if it affects the lungs.
The high incidence of the plague in the country has been attributed to a combination of factors, including poor hygiene and insufficient healthcare.