Bubonic plague and what do we know about the three cases detected in Mongolia & China

Some Spanish and international media have echoed the news of a possible outbreak of the Black Death in Mongolia. Some of this content is linked to a local news item dated March 2019, which has given rise to some confusion. But according to the Chinese news agency Xinhua, there have been three cases of the disease in recent days, two of them in Mongolia. Here's what we know.

The Chinese news agency Xinhua reported on 1 July that two cases of bubonic plague had been confirmed in Khovd province in an area of western Mongolia, according to the Mongolian health minister. The two persons, two brothers, had eaten infected groundhog meat. At that time, local authorities reportedly isolated 146 people who had come into contact with the two sick people, in addition to asking the population not to eat meat from this animal.

According to the same agency, on 5 July another case of bubonic plague was reported in a region of northern China called Inner Mongolia, which has some 25 million inhabitants and borders Mongolia and Russia to the north.

According to this information, in the city of Bayannur, a person affected by this disease and who could have been infected by contact with a groundhog has been admitted to the hospital. According to the agency, local authorities have issued a level 3 pest prevention alert that will last until the end of 2020, citing the risk of person-to-person transmission. The alert levels are 4, with 4 being the lowest.

Among other measures, it has been forbidden to hunt or eat the animals that could be carriers of the disease (rodents). Authorities have also asked the public to report cases of marmots or other similar animals that are sick or dead and any suspected cases of patients with high fevers or who die suddenly.

Local authorities believe that "there is a risk of an epidemic"

According to the China Daily, a newspaper controlled by the Chinese government, the local authorities are said to have stated that "for the time being, there is a risk of a human epidemic of plague in this city. The population should improve its awareness and capacity for self-protection and report abnormal sanitary conditions quickly". Although the carriers are usually rodents, the plague can be spread from person to person by direct contact and through saliva droplets emitted in sneezing or coughing.

Bubonic plague is an illness caused by bacteria and cases occur worldwide

Bubonic plague is a bacterial disease transmitted mainly by the bite of fleas infected with the bacterium Yersinia pestis that live in rodents, such as the groundhog, which in this case the Chinese authorities consider responsible for the contagion.

The disease is characterized by swollen and painful lymph nodes, usually in the groin, armpit, or neck. Other symptoms include fever, chills, headache, and extreme exhaustion, according to the U.S. Centers for Disease Control and Prevention (CDC). It is a disease that since the 1990s, according to the WHO, has been detected mostly in Africa, and especially in the Democratic Republic of Congo, Madagascar, and Peru. In Madagascar, cases are reported every year between September and April.

But it is also found in many areas of Asia, such as northern China and Mongolia, among others. Here you can see a map of potential foci of infection in 2016, always according to WHO, while here is a map of detection of cases between 2013 and 2018, according to the Centres for Disease Control and Prevention (CDC): Plague is not uncommon in China, but outbreaks have become increasingly rare. According to The Guardian, between 2009 and 2018 China has counted 26 cases and 11 victims.

In past centuries (especially the 14th, when it acquired the name "Black Death") it caused hundreds of millions of deaths in Europe. The plague can be treated with antibiotics. However, there is no vaccine. If the plague is treated early with antibiotics, complications and death can be prevented.