As the COVID-19 pandemic rumbles on, the media is discussing news of bubonic plague in Inner Mongolia. Although the headlines appear ominous, the expert opinions below help put the story into perspective.

Colorized scanning electron microscope image of Yersinia pestisShare on Pinterest
Colorized scanning electron microscope image of Yersinia pestis, which is responsible for plague.

Living through a pandemic has heightened the public’s interest in infectious diseases. Just 7 short months ago, none of us would have expected society to freeze in response to a highly contagious pathogen.

Recent news of a case of plague in Inner Mongolia has sparked concerns far and wide. To a public embroiled in a pandemic, the word plague may invoke visions of medieval suffering.

Plague is, by all accounts, a serious and unpleasant disease. Although it is most famous for causing The Black Death, the most fatal pandemic in recorded human history, it never truly disappeared.

Caused by the bacterium Yersinia pestis (Y. pestis), the World Health Organization (WHO) estimate that there are around 650 cases of plague each year globally.

Most cases of plague occur in Asia and Africa, but rural parts of the Western United States register an average of seven cases each year. Plague can be fatal if left untreated, but modern antibiotics can treat it easily.

The recent news reports an isolated case of plague in Bayan Mur, a city in Inner Mongolia. On Sunday, local health officials issued a third-level alert following news that a herdsman had contracted plague.

This is the lowest level of alert and comes with a ban on hunting or eating certain wild animals that could transmit the disease.

According to the China Daily newspaper, a local health authority official said, “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.”

Prof. Jimmy Whitworth, Professor of International Public Health, London School of Hygiene & Tropical Medicine in the United Kingdom, writes:

“Bubonic plague regularly occurs in Mongolia. It normally affects wild rodents and is spread by infected fleas. Humans occasionally get infected if they come into contact with the rodents – in this case, marmots — or fleas. While plague causes severe illness, if it is recognized promptly, then it can be easily treated with antibiotics, and patients will make a full recovery. ”

He explains that “the press reports indicate that this is the case in Inner Mongolia now, suggesting that there is no risk to public health. Two cases of plague were identified in Beijing last year in travelers from Mongolia and were quickly treated with no further spread of infection.”

Echoing this sentiment, Dr. Michael Head, Senior Research Fellow in Global Health, University of Southampton, U.K., writes, “Bubonic plague is a thoroughly unpleasant disease, and this case will be of concern locally within Inner Mongolia. However, it is not going to become a global threat like we have seen with COVID-19. Bubonic plague is transmitted via the bite of infected fleas, and human to human transmission is very rare.”

“This is not worrying at all,” says Prof. David Mabey, Professor of Communicable Diseases, London School of Hygiene & Tropical Medicine, U.K. “Y. pestis remains fully susceptible to a number of antibiotics.”

Currently, it seems that there has only been one case of plague in Inner Mongolia. This means that the health authority can isolate and treat the individual, which will prevent further transmission.

“So although this might appear alarming, being another major infectious disease emerging from the east, it appears to be a single suspected case which can be readily treated,” explains Dr. Matthew Dryden, Consultant microbiologist, Hampshire Hospital NHS Trust, University of Southampton & Rare and Imported Pathogens Department, U.K.

Dr. Dryden continues:

“The risk of transmission to and explosive outbreaks amongst humans, as happened in the middle ages and up to the antibiotic era, is very unlikely at present as the bacterium causing plague remains sensitive to antibiotic treatments. It is important that we use antibiotics appropriately and sparingly to retain the activity of these important drugs.”

Although plague is a serious disease, doctors can treat it easily with antibiotics. As it stands, people outside of Inner Mongolia do not need to lose any sleep over the situation there.

While we weave our way through the current pandemic, many of us are feeling more anxious than usual about potential threats to our health. This is understandable and normal. However, the recent news from Inner Mongolia should not remain at the top of our list of concerns.