Officials in China have issued a warning following confirmed cases of the bubonic plague.
The disease, which was responsible for one of the deadliest recorded pandemics in human history: the Black Death – was contracted first by a herdsman from Bayannur, in Inner Mongolia.
The first case was reported on Saturday at a hospital in Urad Middle Banner, in Bayannur city. It is not yet clear how or why the patient became infected.
The second suspected case involves a 15-year-old, who had apparently been in contact with a marmot hunted by a dog, a tweet from Global Times said.
The man is in quarantine in a stable condition and his brother has subsequently been confirmed to have the disease, according to NDTV.
The brothers are reported to have eaten marmot meat and people have now been asked to report any sightings of ill or dead marmots.
Officials have issued a Level 3 warning, the second-lowest in a four-tier system, whereby people are banned from hunting and eating animals that could carry the plague, such as rodents.
The local health authority told China Daily: “At present, there is a risk of a human plague epidemic spreading in this city. The public should improve its self-protection awareness and ability, and report abnormal health conditions promptly.”
Bubonic plague is caused by a bacterial infection and can be fatal if not treated. However, it is unlikely the disease will proliferate and devastate as it has in previous centuries due to advancements in our understanding and treatment of the plague.
Dr Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told Healthline: “Unlike in the 14th century, we now have an understanding of how this disease is transmitted.
“We know how to prevent it – avoid handling sick or dead animals in areas where there is a transmission.
“We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria and prevent them from getting sick.”
The Black Death pandemic claimed around 50 million lives across Africa, Asia and Europe, and The Great Plague in 1665 wiped out about a fifth of London’s population.
While cases have become increasingly rare and easier to treat, the disease still claims lives.
China recorded 26 cases of bubonic plague between 2009 and 2018, resulting in 11 deaths. Two people also died in Mongolia last year after eating the raw kidney of a marmot, which some in the region believe to bring good health.
Symptoms of bubonic plague – which typically develop after three to seven days – include fever, headaches, vomiting and swollen lymph nodes; however, it often goes unidentified initially due to the flu-like nature of the symptoms.