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The bubonic plague is back in China’s Inner Mongolia

According to the state-run Xinhua news agency, the case was discovered in the city of Bayannur, northwest of Beijing. A hospital alerted the city authorities on Saturday of the patient’s case. By Sunday, local authorities had issued a city-wide level 3 pest prevention warning, the second lowest in a four-tier system.

According to Xinhua, the warning will remain in effect until the end of the year.

The plague caused by bacteria and transmitted by flea bites and infected animals is one of the deadliest bacterial infections in human history. An estimated 50 million people were killed in Europe during the Black Death in the Middle Ages.

The bubonic plague, one of the three forms of the plague, causes painful, swollen lymph nodes as well as fever, chills and cough.

Bayannur health officials are now asking people to take additional measures to minimize the risk of human-to-human transmission and to avoid hunting or eating animals that could cause infections.

“There is currently a risk of an epidemic of human plague spreading in this city. The public should improve their self-awareness and skills, and report abnormal health conditions immediately,”
; the local health agency said, according to the China Daily newspaper.

Bayannur authorities have warned the public to report finds of dead or sick marmots – a type of large ground squirrel that is eaten in some parts of China and neighboring Mongolia and has historically caused epidemic outbreaks in the region.

A tarbagan marmot in steppes around Khukh Lake, Mongolia.

The groundhog is believed to have caused the 1911 pulmonary plague epidemic, which killed approximately 63,000 people in northeastern China. It was hunted for its fur, which became increasingly popular with international traders. The diseased fur products were traded and transported across the country – and infected thousands.

Although this epidemic was contained within a year, marmot-related plague infections persist decades later. Last week, two cases of bubonic plague were confirmed in Mongolia – brothers who, according to Xinhua, had both eaten marmot meat.
Last May, a couple died of bubonic plague in Mongolia after eating the raw kidney of a marmot, which is considered a folk remedy for good health. Two other people fell ill with lung plague across the border in Inner Mongolia – another form of the disease that infects the lungs.

Why is the plague still a thing?

The advent of antibiotics, which can treat most infections if they are detected early enough, has helped stem puberty outbreaks and prevented the rapid spread of witnesses in Europe in the Middle Ages.

Although modern medicine can treat the plague, it hasn’t completely eliminated it – and it has recently made a comeback, prompting the World Health Organization (WHO) to classify it as a recurring disease.

According to the WHO, 1,000 to 2,000 people contract the plague every year. However, this amount is probably an underestimated estimate because it does not take into account unreported cases.

Every year between 1,000 and 2,000 people contract the plague - around 7 of them in the United States

The three most endemic countries – meaning the plague persists there – are the Democratic Republic of the Congo, Madagascar and Peru.

In the United States, the Centers for Disease Control and Prevention report several to several dozen plague cases each year. Two people died of the plague in Colorado in 2015, and eight cases were reported in the state the year before.

There is currently no effective vaccine against the plague, but modern antibiotics can prevent complications and death if given quickly enough. Untreated bubonic plague can turn into pulmonary plague, which causes rapidly developing pneumonia after bacteria have spread to the lungs.

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