Deadly plague struck again a village in Madagascar , Africa , said a medical official in the country .
Last week at least 20 people were killed in a village in the northeast of the island nation .
International Committee of the Red Cross has previously been issued a warning last October that Madagascar is at risk of contracting plague is transmitted to humans by ticks - usually derived from mice .
Bubonic plague known as the Black Death Click in the country , killing about 25 million people in Europe during the Middle Ages , but now increasingly rare .
Last year , Madagascar recorded 60 deaths from this outbreak , the highest figure recorded in the world .
The BBC's Tim Healy in the capital , Antananarivo , said health officials have set out to the remote area to investigate .
Detainees at the prison on the island are usually the most affected by the epidemic because of unhygienic conditions , he said .
There is concern that the disease could spread to towns and cities where the standard of living declined since a coup in 2009 and the political crisis .
On December 20, will be held the second round of presidential elections to end the political deadlock .
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