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UNITED NATIONS (AP) — The number of plague cases in Madagascar has almost doubled over the last five days and medical experts project the situation will worsen, with 1,000 cases expected every month if funds aren’t rapidly provided, the United Nations said Thursday.

U.N. spokesman Stephane Dujarric told reporters that only 26 percent of the $9.5 million needed to combat the outbreak of the often deadly disease has been received.

Dujarric said U.N. humanitarian officials in the Indian Ocean island nation reported 1,032 cases as of Wednesday, 67 percent of which were pneumonic plague. He says that “is more serious than the bubonic plague and highly challenging to control.”

So far, he said, 89 deaths have been counted, including 13 on Tuesday.

Dujarric said U.N. officials have strengthened systems to identify contacts of victims, monitor the number of patients at hospitals, transport medical samples, and address “the transmission risks of traditional burial practices.”

Madagascar has about 400 plague cases per year, or more than half the world’s total, according to a 2016 World Health Organization report. Usually, they are cases of bubonic plague in the rural highlands. Bubonic plague is carried by rats and spread to humans through flea bites. It is fatal about half the time if untreated.

For the first time, though, this outbreak is largely concentrated in the country’s two largest cities, Antananarivo and Toamasina.

Most of the cases in the current outbreak are pneumonic plague, a more virulent form that spreads through coughing, sneezing or spitting and is almost always fatal if untreated. In some cases, it can kill within 24 hours. Like the bubonic form, it can be treated with common antibiotics if caught in time.

Global health officials have responded quickly.

The World Health Organization, criticized for its slow response to the 2014 Ebola epidemic in West Africa, has released $1.5 million and sent plague specialists and epidemiologists. The Red Cross is sending its first-ever plague treatment center to Madagascar.

But, Dujarric said, “Medical experts project that the situation will continue to deteriorate, with 1,000 cases per month expected if the response is not rapidly funded.”