The Black Death appears in China for the second time this year, as in May, a Mongolian couple died of bubonic plague after eating the raw kidney of a marmot, a local popular health remedy. This “medieval” infection is one of the deadliest pandemics in human history, costing approximately 25 million lives in Europe along with another 40 to 60 million in Africa and Asia.

The patients, from the Chinese province of Inner Mongolia, were diagnosed with pneumonic plague by doctors in the Chinese capital of Beijing, according to state media Xinhua. They are now under treatment in Beijing’s Chaoyang district, and the authorities have implemented preventive control measures.

In the 19th century, China suffered an outbreak known as the modern plague, which claimed some 10 million lives.

Pest Facts and Figures

  • The plague is caused by Yersinia pestis, a zoonotic bacterium often found in small mammals and the fleas that parasitize them, WHO says.
  • People infected with Y. pestis usually show symptoms after an incubation period of one to seven days.
  • There are two main clinical forms of plague: bubonic and pneumonic. Bubonic plague, characterized by painful swelling of the lymph nodes, called bubons, is the most common.
  • Plague is transmitted between animals and humans by the bite of infected fleas, direct contact with infected tissues or inhalation of infected respiratory droplets.
  • Plague can be a very serious disease for humans. In the absence of treatment, bubonic plague has a case fatality rate of 30% to 60%, and pneumonic plague is invariably fatal.
  • Antibiotic treatment is effective against plague, so early diagnosis and treatment can save human lives.
  • Between 2010 and 2015, 3248 cases were reported worldwide, 584 of them fatal.
    Currently, the three most endemic countries are Madagascar, the Democratic Republic of Congo and Peru.
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Treatment

In the absence of treatment, pneumonic plague can lead to death within a short time, so early diagnosis and treatment are essential for survival and to reduce complications. Antibiotics and supportive care are effective if plague is diagnosed early. If left untreated, pneumonic plague can be fatal within 18 to 24 hours of the onset of the disease, but antibiotics commonly used against enterobacteria (Gram-negative bacilli) can cure it if given promptly.

Prevention

Preventive measures include informing the population when zoonotic plague is present in their environment and recommending that they take precautions against flea bites and do not handle animal carcasses. Direct contact with infected body tissues and fluids should also be avoided. General precautions should be applied during contact with potentially infected patients and the collection of samples.