• Health: China records several cases of bubonic plague
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Chinese authorities have confirmed that a pastor in the Inner Mongolia region is infected with bubonic plague. The Bayannur City Health Commission, where the patient is admitted in a stable condition, has declared a level 3 alert (the second lowest in a four-level system) and the regional government has asked its inhabitants not to hunt , consume or transport potentially infected animals - particularly groundhogs - and report any dead or diseased rodent so that it can be tested.

The bubonic plague, responsible for the pandemic that decimated the populations of Europe and Asia in the 14th century, is caused by a bacterium, Yersinia pestis . It is transmitted mainly through fleas that infect rodents or by direct contact with them. Although the last major outbreak occurred in the early 20th century, human plague cases are still relatively common worldwide. The three countries most affected in this decade are Madagascar, the Democratic Republic of the Congo and Peru , although cases have also been registered in Zambia, India, Malawi, Algeria, China and Mongolia so far this century.

In regions where the disease is endemic, plague continues to circulate as an epizootic (animal epidemic) in subsoil rodents . In the case of Inner Mongolia, guests are usually groundhogs, very abundant in rural areas. Russia has already launched patrols to prevent hunting this animal on its border with China and Mongolia, after both countries reported other suspected cases. "At the moment we do not consider that there is a high risk, but we are closely monitoring the situation with the Chinese and Mongolian authorities," said Margaret Harris, spokeswoman for the World Health Organization (WHO).

Antibiotic treatment

Experts explain that the chances of reported cases in Asia spreading beyond these countries are slim. "The plague is endemic (it is always present at low levels) in wild animals in this region, and a few cases in humans appear every year," explains Dr. Susan D. Jones, specialist in Ecology of diseases at the University from Minnesota. "A person contracts the disease from direct contact with sick animals; unless it becomes a lung infection it does not spread easily between people." On the other hand, experts explain that although Y. pestis is a virus capable of mutating, "in the past it has mutated very slowly , it is not like coronavirus or influenza, which can mutate rapidly."

Although bubonic plague was once the world's most feared disease, it can now be easily treated with antibiotics, "so most patients recover and don't spread it," says Jones. Symptoms include high fever, chills, nausea, weakness, and swollen lymph nodes. In cases where the disease affects the lungs, it is called pneumonic plague, the most severe and most contagious form . The WHO explains that pneumonia is always fatal if it is not treated promptly and that it can trigger serious epidemics with person-to-person transmission through airborne respiratory droplets.

Thus, Madagascar experienced an outbreak with more than 2000 cases in 2017, which caused more than 200 deaths. " Climatic, ecological and social conditions can cause a temporary outbreak. Cases multiply then, the risk of pneumonic plague increases and the situation can be more difficult to manage," explains Alice Lebreton, from the Institut de Biologie de l'École Normale. Supérureure de Paris. "But I think the current situation in Mongolia and China has nothing to do, partly because of the experience in controlling the plague in this region, and partly because of the very low population density in this rural area."

Eradication failures

Despite the large-scale efforts of programs such as the one deployed by the Soviet Union in Central Asia, the disease has not been completely eradicated . Since then, the health authorities favor a control strategy and not one of elimination. "It is unlikely that the pest will be eradicated worldwide, due to the existence of ecologically complex animal reserves that will continue to harbor the bacteria," says Lebreton. "Attempts to eradicate insects, through the massive use of insecticides, or rodents were ecologically disastrous and quite ineffective, as populations always recover."

In May last year, two people died in Mongolia from the plague, which they contracted after eating raw groundhog meat. Regarding Europe, although the continent was violently affected in other periods, during the Justiniana Plague and the Black Plague, the bacillus is not endemic. In a 2018 report, the European Center for Disease Prevention and Control (ECDC) noted that there has been no case of plague "for several decades" on the continent.

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