China’s health authorities have sounded a high alert after a suspected case of the infectious bubonic plague was reported on July 5 from Inner Mongolia. Two cases of the same plague were reported from the same northern province eight months ago.

Beijing and Inner Mongolia reported two cases of an even more infectious pneumonic plague in November 2019.

The Bayannur municipal health commission on July 5 said that the people’s hospital in Urad Middle Banner reported the suspected bubonic plague case in local herdsman on July 4.

The patient has been isolated and is undergoing treatment in a local hospital. Local authorities in Bayannur issued a third-level warning for the prevention and control of the plague that will last till the end of this year.

The commission issued an advisory for residents in the area to prevent people-to-people infection, including not to hunt and consume animals that could lead to the spread of the plague infections.

The public has been asked to ‘report any findings of killed or dead marmots and other animals, and report suspected plague cases, high fever patients with unknown reasons and patients dying from sudden deaths’.

There are three types of plague, a bacterial infection caused by Yersinia pestis: septicemic, which spreads in the blood; bubonic, which impacts the lymph nodes; and pneumonic, which affects the lungs.

The last two types were reported in Inner Mongolia and in Beijing in November 2019.

According to the American Centers for Disease Control and Prevention (CDC), while the bubonic plague spreads through fleas hosted by infected animals, like rodents, it claimed millions of lives in medieval Europe before spreading to Asia and Africa in the 14th century. The pneumonic plague, however, spreads through cough droplets.

Symptoms include persistent high fever, coughing with blood, and chest pain. Bubonic plague is more common, but pneumonic is more dangerous.

In 2014, China had locked down Yumen after one person died of bubonic plague, and as many as 151 people were quarantined.

According to China’s national health commission (NHC), five people have died from the plague between 2014 and September 2019. The most recent outbreak of pneumonic plague occurred in Madagascar in 2017, with about 2300 confirmed cases and 202 deaths, as per the World Health Organisation.

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