The plague outbreak in Madagascar is continuing to grow and spread at an unprecedented rate with about 57 people dead and more than about 680 cases of the outbreak having been reported. The latest figures come from Oct. 12. An estimated about 329 cases of the outbreak have occurred in Antananarivo, Madagascar’s capital, and there have been about 25 deaths. The National Bureau for Risk and Disaster Management (BNGRC, as it’s abbreviated in French), and the World Health Organization (WHO) have been reporting the causes of the outbreak in Madagascar.

While the country experiences regular outbreaks, with an estimated 400 cases of the plague each year, this time things are very different, experts warn. Health officials have reported that this year the infections have started much earlier than usual, occurring in urban settings and new areas. According to WHO, of the 684 cases reported as of Oct. 12, 474 of the cases were pneumonic plagues, 156 of the cases of the plague are bubonic, and one case is of the septicemic plague. The other 54 cases were unspecified.

Plague is usually caused by an infection with the bacteria Yersinia pestis and is typically spread mostly through the bite of an infected fleas, frequently carried by rats causing bubonic plague. The symptoms include fever, chills, painful swollen lymph nodes called buboes, and coughing. Pneumonic plague is more virulent and damaging, being an advanced form characterized by a severe lung infection. The infection can be transmitted from person to person via airborne sneezing and coughing. The infected person may die within 12 to 24 hours. Both forms can be treated with antibiotics if the infected person treats it early enough. CNN was able to interview the UK Public Health Rapid Support Team (UKPHRST).

 “The international community is taking this very seriously,” director of UKPHRST Daniel Bausch said.

Launched in 2016, this team consists of clinicians, scientists and academics deployed to tackle outbreaks of disease around the world within 48 hours. WHO delivered more than 1.2 million doses of antibiotics and released $1.5 million in emergency funds earlier this month.

The outbreak has escalated this year because the surprising occurrence caught the cities off guard. Typically the outbreak happens in the rainy season around November and December, but this year it started three months earlier in August.