Officials may have identified one case of the bubonic plague, the disease at the center of the Black Death, in China’s Inner Mongolia region.
Local health authorities at the Bayannur municipal health commission reported a potential case of the bubonic plague on Saturday, according to state media. On Sunday, the commission issued a level-three health warning, one notch above the least serious alert in a four-level system.
Local officials warned residents against hunting and eating potentially infected animals and requested they report rodents suspected of carrying the disease. The level-three alert and plague-prevention protocol will remain in place for the rest of 2020.
The case of the centuries-old plague was identified in a rural herdsman, local officials told The New York Times. In China’s Mongolia region, the disease is most often carried by marmots, a type of ground squirrel, and is transmitted by infected fleas. Human-to-human transmission of the disease is rare.
An outbreak of the bubonic plague in the 14th century killed tens of millions of people across Europe in what became known as the Black Death. The illness is fatal in an estimated 30-60% of untreated cases, but it can be treated with antibiotics if caught early, according to the World Health Organization. The WHO gives the following description of the disease:
Bubonic plague is the most common form of plague and is caused by the bite of an infected flea. Plague bacillus, Y. pestis, enters at the bite and travels through the lymphatic system to the nearest lymph node where it replicates itself. The lymph node then becomes inflamed, tense and painful, and is called a ‘bubo’. At advanced stages of the infection the inflamed lymph nodes can turn into open sores filled with pus. Human to human transmission of bubonic plague is rare.
The bubonic plague, if it spreads to the lungs, can turn into the pneumonic plague, a condition that kills the patient within 24-48 hours if left untreated. According to the WHO:
Untreated pneumonic plague can be rapidly fatal, so early diagnosis and treatment is essential for survival and reduction of complications. Antibiotics and supportive therapy are effective against plague if patients are diagnosed in time. Pneumonic plague can be fatal within 18 to 24 hours of disease onset if left untreated, but common antibiotics for enterobacteria (gram negative rods) can effectively cure the disease if they are delivered early.
While the chance of a repeat of the Black Death event is small, reported cases of the bubonic and pneumonic plague are common, especially in rural regions of the world. From 2010 to 2015, authorities reported 3,248 cases of the diseases worldwide, including 584 deaths, according to the WHO.
Several cases of the pneumonic plague appeared in China’s Inner Mongolia region last year. In November, a couple was diagnosed with the disease and treated at Chaoyang Hospital in Beijing. Several months earlier, another couple died from the plague after contracting it from eating raw organ meat from marmots.
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