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A second man has died from plague in the city of Ziketan, in northern China. The local authorities have quarantined about ten people who were exposed to either of the dead men.
Plague is the Black Death. It decimated cities and countrysides, and entire nations as it swept across the continent in repeated waves. The National Institute of Allergy and Infectious Diseases suggests that it killed one third of the population of Europe, 30 million people, in the 1300's. In the mid 1800's it killed 12 million Chinese.
Plague is spread in two main forms, pneumonic - which is the form reported in China, and bubonic. Pneumonic plague is spread like many respiratory diseases, by being coughed or sneezed on by a sick person.
Bubonic plague can be found in the United States, almost entirely in the Southwest. It is spread by the bites of fleas, usually fleas from rats, mice or other rodents. The number of human cases varies with the natural increases or decreases in rodent populations. The NIH reports 10-20 cases of bubonic plague in the U.S. on average each year. 1 of 7 cases is fatal.
Pneumonic plague appears as a rapid onset pneumonia, with all the related symptoms, fever, shortness of breath, coughing and sometimes bloody sputum. It is very contagious for people who have close contact with the patient. The Y. pestis bacteria cannot survive longer than about an hour in open air and sunlight so personal contact is the most risky.
Cases of pneumonic plague also appear when the bubonic plague travels to a patients lungs. This explains the appearance of this form of the illness in the absence of other cases.
Improved sanitation, including pest control, has banished bubonic plague from most modern cities. Controlling rats and mice is the key to preventing this illness. The cases seen in the United States are from the rural Southwest where a reservoir of plague exists among the wild rodent population.
Eliminating rats and mice from human living space has brought many improvements in public health. Turning the Black Death into a curiosity and a story from China is just one.
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