Authorities in Madagascar are struggling to contain an outbreak of plague that has killed two dozen people in recent weeks.
A ban has been imposed on large public gatherings in the capital to curb the disease's spread.
The dead include a basketball coach from the Seychelles who was participating in a tournament in Madagascar's capital, Antananarivo.
Five people have died of plague in the capital, reported L'Express de Madagascar, a daily newspaper.
The government has begun a campaign to disinfect school classrooms in the city, compelling students to stay at home in the coming days.
Many people have bought surgical masks and other medical supplies in large quantities, raising concerns about a shortage of medicine.
"Once everybody hears that this is a major thing, everyone runs out and buys everything at the pharmacy," said Joshua Poole, the Madagascar representative for Catholic Relief Services, an aid group based in Baltimore, Maryland in the US.
"Access to those essential items is a challenge."
Mr Poole said the death of the basketball coach from the Seychelles had attracted more international attention to this year's outbreak of plague, which is endemic to Madagascar.
The coach, 49-year-old Alix Allisop, died in a hospital after experiencing breathing problems, according to the Seychelles News Agency.
A jazz festival, Madajazzcar, cancelled its opening concert in Antananarivo this week and suspended other events until further notice.
Plague has also been reported in the port city of Toamasina in eastern Madagascar and other cities.
At least 114 people have been infected with plague and the disease is affecting large urban areas unlike like past outbreaks, increasing the risk of transmission, the World Health Organisation said on Sunday.
WHO, which is sending more staff and supplies, including antibiotics, to Madagascar, said about 400 case of plague, mostly bubonic, are reported every year in the country.
The last reported outbreak in Madagascar occurred in a remote area in December 2016 and was mostly bubonic plague, the United Nations health agency said.
"Bubonic plague is spread by infected rats via flea bite, pneumonic by person-to-person transmission. The current outbreak includes both forms of plague," the agency said.
It described plague as a "disease of poverty" that can kill quickly if untreated but can be cured if antibiotics are administered early.