The United Nations health agency has sent a medical team to Madagascar in an effort to identify a mystery illness that has killed at least 184 people.
The viral infection, with symptoms similar to flu, is thought to have affected 1,900 people in the last two months in the Indian Ocean island.
The outbreak is thought to have started in Fianarantsoa in Madagascar's central highlands, the poorest province in the country, 217 miles [350 kilometres] south of the capital Antananarivo.
Hundreds of people have been treated for headaches, pains and stomach cramps, health officials from the Malagasy Government said.
Poor communities affected
The World Health Organisation said experts and scientists from the French Pasteur Institute had travelled to the affected province to help identify the illness.
Most of the victims live in poor, isolated rural communities with little infrastructure which goes some way to explain why they have been so badly hit.
The hangover from the seven-month political crisis may also be a factor.
Average incomes across the country have been halved with the collapse of the economy, and money is being spent on food rather than medicines.
Children and the elderly have been particularly vulnerable to the illness.