Authorities in the Chinese region of Inner Mongolia are on high alert after a suspected case of bubonic plague, the disease that caused the Black Death pandemic, according to state-run Xinhua news agency.

According to state reports, the Bayannur patient – a herdsman – is in quarantine and in a stable condition. Officials issued a Level 3 warning, the second-lowest in a four-tier system. The bubonic plague, caused by a bacterial infection, can be deadly but can be treated with commonly available antibiotics.

Plague, caused by bacteria and transmitted through flea bites and infected animals, is one of the deadliest bacterial infections in human history. During the Black Death in the Middle Ages, it killed an estimated 50 million people in Europe.

Bubonic plague, which is one of plague’s three forms, causes painful, swollen lymph nodes, as well as fever, chills, and coughing.

Bayannur health authorities are now urging people to take extra precautions to minimize the risk of human-to-human transmission and to avoid hunting or eating animals that could cause infection. “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,” the local health authority said, according to state-run newspaper China Daily.

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Bayannur authorities warned the public to report findings of dead or sick marmots — a type of large ground squirrel that is eaten in some parts of China and the neighboring country Mongolia, and which have historically caused plague outbreaks in the region.

“Unlike in the 14th Century, we now have an understanding of how this disease is transmitted,” Dr Shanti Kappagoda, an infectious diseases doctor at Stanford Health Care, told news site Heathline.

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“We know how to prevent it. We are also able to treat patients who are infected with effective antibiotics.”

Its last terrifying outbreak in London was the Great Plague of 1665, which killed about a fifth of the city’s inhabitants. In the 19th Century there was a plague outbreak in China and India, which killed more than 12 million.