Eight people have died in two days of pneumonic plague on the Indian Ocean island of Madagascar which is hit by deadly outbreaks almost every year, a health ministry official said Wednesday.

Pneumonic plague is rare and more vicious than the commonly-known bubonic strain as it gives antibiotics little time to act and can kill within 24 hours.

"Twelve cases of pneumonic plague have been identified," out of which eight people have died in two days, Maherisoa Ratsitorahina, the health ministry's chief epidemiologist, told AFP.

He said the disease was under control and was confined to Antsahatsihanarina village, which is less than 20 kilometres (12 miles) from the city of Moramanga in the east of the island.

Plague is endemic in Madagascar where outbreaks have resurfaced often since 1980 and are blamed mainly on rats and flea infestation due to unbridled deforestation.

Pneumonic plague can be spread from person to person through coughing.

The World Health Organization warned early this year that the number of plague cases has steadily increased over the last three years, making Madagascar the world's most affected country.

In 2013, the country registered 86 cases and 39 deaths while between September last year to February, a total of 263 people were infected cases and at least 71 killed.