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Two people got the plague in China. Why is that still a thing?

The two new patients, from the Chinese province of Inner Mongolia, were diagnosed with pneumonic plague by doctors in the Chinese capital Beijing, according to state media Xinhua. They are now receiving treatment in Beijing's Chaoyang district, and the authorities have implemented preventive control measures.

Plague, caused by bacteria and transmitted through bites and infected animals, can develop in three different forms. Bubonic plague causes swollen lymph nodes, while septicemic plague infects the blood and pneumonic plague infects the lungs.

Pneumonic – the type that Chinese patients have – is more virulent and harmful. If the World Health Organization (WHO) is left untreated, it is always fatal.

During the Middle Ages, plague outbreaks destroyed Europe and killed about 50 million people. Since then, we have invented antibiotics, which can treat most infections if caught early enough ̵

1; but the plague is not gone. In fact, a recent comeback has been made.

  Pest-infected prairie dogs have shut down parts of a Denver suburb
From 2010 to 2015, more than 3,248 cases were reported worldwide, including 584 deaths, according to WHO. The three most endemic countries are the Democratic Republic of Congo, Madagascar and Peru.

In the United States, there have been anywhere from a few to a few dozen cases of plague each year, according to the Centers for Disease Control and Prevention. In 2015, two people in Colorado died from the plague, and the year before, there were eight reported cases in the state.

After causing nearly 50,000 human cases over the past 20 years, the plague is now categorized by the WHO as a recurring disease.

How do you get plague? Is it curable?

According to the CDC, people usually get plague after being bitten by a rodent flea that carries the bacterium Yersinia pestis. Infected animals such as cats and dogs can also infect their owners.

The bacteria persist because low levels circulate among populations of certain rodents, says the CDC. These infected animals and their fleas act as long-term reservoirs for the bacteria.

A 2018 study suggested that it is not only rats that are responsible – Black death may have been spread by human fleas and body lice.
  Black Death spread of humans, waving rats

There is currently no effective vaccine against plague, but modern antibiotics can prevent complications and death if given quickly enough. However, a strain of bubonic plague was seen with high-level resistance to antibiotic streptomycin, which is usually the first-line treatment, recently in Madagascar.

Untreated bubonic plague can turn into a pneumonic plague, causing rapidly developing pneumonia, after bacteria spread to the lungs.

A new report suggests that researchers are investigating different methods for developing an effective vaccine. Because different vaccine designs lead to different mechanisms of immunity, the authors conclude that combinations of different types can overcome the limitations of individual vaccines and effectively prevent an outbreak of plague.

How do you protect yourself against the plague?

Important steps to prevent plague include eliminating rodent nesting sites around your home, shed, garage and recreation area by removing brush, piles, debris and excess wood, according to the CDC.

Report sick or dead animals to law enforcement or your local health care officials, do not record or touch them yourself. If you absolutely have to deal with a sick or dead animal, wear gloves.

Use insecticides containing DEET to prevent flea bites and treat dogs and cats for fleas regularly. Do not sleep with your pet as it increases the risk of becoming plague. Lastly, your pets should not hunt or roam rodent habitats, such as prairie dog colonies.

Susan Scutti contributed to this report.

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