China: 3-year-old diagnosed with Bubonic plague; is 'Black Death' back? All you need to know

A boy in China has been infected with bubonic plague, a centuries-old disease that caused a major outbreak in 2009, Fox News reported.

The 3-year-old from Menghai county, located in southwestern China, suffered a mild infection but is now in stable condition following treatment, the Global Times of India reported. No other infections have reportedly been identified.

Chinese authorities in the region have started a level IV emergency response to prevent another epidemic following the Covid-19 outbreak, reported Global Times.

The boy’s case came to light following a countywide screening for the disease, which was prompted after “three rats were found dead for unknown reasons in a village,” the outlet reported.

Earlier, in August, authorities in North China's Inner Mongolia Autonomous Region had sealed off a village after a resident died of Bubonic plague. Inner Mongolia had also reported four cases of bubonic plague in November 2019.

What is plague?

Plague is an infectious disease, caused by the bacteria Yersinia pestis, a zoonotic bacteria usually found in small mammals and their fleas. People can contract plague if they are bitten by infected fleas, and can develop the bubonic form of plague.

Sometimes bubonic plague progresses to pneumonic plague when the bacteria reach the lungs. Common antibiotics are efficient to cure plague, only if they are given at an early stage. Plague can be a very severe disease in people, with a case-fatality ratio of 30% to 60% for the bubonic type, and is always fatal for the pneumonic kind when left untreated.

Is person-to-person transmission possible?

Person-to-person transmission is possible through the inhalation of infected respiratory droplets of a person who has pneumonic plague.

Types of plague

There are two main forms of plague infection, depending on the route of infection.

1. Bubonic plague

It is the most common form of plague globally and is caused by the bite of an infected flea. Human to human transmission of bubonic plague is rare, reports WHO. However, it can advance and spread to the lungs, which is the more severe type of plague called Pneumonic plague.

2. Pneumonic plague (lung-based plague)

It is the most virulent form of plague. Incubation can be as short as 24 hours. Any person with pneumonic plague may transmit the disease via droplets to other humans. Untreated pneumonic plague can be fatal. However, recovery rates are high if detected and treated in time (within 24 hours of the onset of symptoms).

Symptoms of bubonic plague

Symptoms include fever, chills, head and body aches and weakness, vomiting, and nausea. Painful and inflamed lymph nodes can also appear during the bubonic plague.

Prevention and treatment

To prevent bubonic plague, avoid touching dead animals, and wear insect repellent while in plague endemic areas. Plague can be treated with antibiotics, and recovery is common if treatment starts early.

In plague-outbreak areas, people with symptoms should go to a health centre for evaluation and treatment. Currently, the three most endemic countries are the Democratic Republic of the Congo, Madagascar, and Peru.

The plague that caused 50 million deaths in 14th century

China has largely eradicated the plague, but occasional cases still occur. The country has reported 26 cases and 11 deaths from 2009 to 2018.

Historically, the plague was responsible for widespread pandemics with high mortality. It was known as the "Black Death" during the fourteenth century, causing more than 50 million deaths in Europe.