Amid the coronavirus disease (COVID-19) pandemic, another health threat has emerged in a city in the Chinese region of Inner Mongolia.
Mongolia has issued a warning to residents in the western Khovd region after four people are suspected of having the bubonic plague. The National Center for Zoonotic Diseases (NCZD) states that the disease is linked to the consumption of marmots, a relatively large ground squirrel.
Marmot. Image Credit: Ondrej Prosicky / Shutterstock
The first suspected bubonic plague case was reported on July 4 at a hospital in Urad Middle Banner in Bayannur City. It is unclear how the patient contracted the virus.
Meanwhile, the second patient is a 15-year-old who had been in contact with a marmot that had been hunted by a dog.
Two other cases were confirmed in Mongolia’s Khovd province involving brothers who had eaten marmot meat.
The health committee of Bayan Nur City issued a third-level alert, the second-lowest in a four-level system. This prohibits the hunting and eating of animals that could carry the plaque. The public is advised to report any suspected cases of plague or fever with no apparent causes. They also asked residents to report sick or dead marmots.
Last year, Mongolia had declared a lockdown in Bayan Olgyi, in the western part of the country, after two plague cases emerged in the area.
What is the bubonic plague?
The bubonic plague, or the Black Death, is the most fatal pandemic recorded in human history killing an estimated 75–200 million people in Europe in the mid-1300s. Bubonic plague is caused by the bacteria Yersinia pestis, a gram-negative, non-motile, rod-shaped, coccobacillus bacterium, with no spores. It can be transmitted to humans after fleas bite infected rodents, mice, and marmots.
Bubonic plague bacteria Yersinia pestis. Image Credit: Kateryna Kon / Shutterstock
The World Health Organization (WHO) says that people with the infection often develop symptoms after an incubation period of one to seven days. There are three types of plagues, the bubonic plague, which is the most common, the pneumonic plague, and the septicemic plague.
Bubonic plague is characterized by swollen and painful lymph nodes or “buboes.” The pneumonic plague may result from secondary infection of the lungs after the spread of the plague from other body sites. It causes pneumonia and may be transmitted through respiratory droplets. Septicemic plague results from bubonic plague, which may cause severe health consequences, such as meningitis, endotoxic shock, and disseminated intravascular coagulation.
In some individuals, plagues can cause severe disease, with a case-fatality ratio of between 30 and 60 percent. It is usually transmitted between animals and humans through the bite of infected fleas, direct contact with infected tissues, and inhalation of infected respiratory droplets.
The good news is, the bacteria can be treated with antibiotic treatment, but early detection and treatment are crucial. Between 2010 and 2015, more than 3,200 cases were reported across the globe, with 548 deaths. The three endemic countries include Congo, Madagascar, Peru, and the Dominican Republic. Every year, thousands of cases of the plague are still reported to the World Health Organization.
Is it another epidemic?
The world is currently grappling with the coronavirus pandemic, with more than 11.57 million infected and at least 536,000 dead. Though Mongolia reports a low infection and death toll caused by COVID-19, the emergence of the plague raised the alarm across the nation.
Bubonic cases are rare, but there can be flare-ups of the disease now and then. In 2017, Madagascar had reported more than 300 cases of the plague, but less than 30 people died. Last year, two people died in Mongolia after eating the raw meat of a marmot and contracted the bacteria.
Despite this, health officials said that it is unlikely to cause an epidemic.
“Unlike in the 14th Century, we now have an understanding of how this disease is transmitted. We know how to prevent it. We are also able to treat patients who are infected with effective antibiotics.” Dr. Shanti Kappagoda, an infectious diseases doctor at Stanford Health Care, said.
The International Association for Medical Assistance to Travelers (IAMAT) issued a warning, stating that the risk of plague is present throughout Mongolia, including the districts of Bayanhongor, Bayan-Olgiy, Govi-Altai, and Dzavhan. The transmission risk is also present all-year-round.
The agency recommends that all accommodations and camping sites for tourists should be free of rodents. Also, it urges everyone to remove food sources or potential nesting materials, avoid contact with mice, rodents, carnivores who are rodents, and dead animal tissues.