Authorities in Mongolia have lifted a quarantine on a town after a man and his reportedly pregnant wife died from the bubonic plague, allowing tourists to leave the area.
The six-day quarantine left nine tourists from Russia, Germany and Switzerland stranded in the town of Ulgii on the border with Russia and China.
"The two dead were local people," local governor Aipiin Gilimkhaan said.
"There were no cases reported after them."
A German tourist named Teresa, said “we are all fine. No one is ill”.
A 24-year-old American Peace Corps volunteer Sebastian Pique said the governor invited him and the tourists to his office to tell him about the situation.
"After the quarantine (was announced) not many people, even locals, were in the streets for fear of catching the disease," he said.
Officials said the ethnic Kazakh couple ate marmot, which is a rodent, and died.
Dr Allen Cheng, a professor of infectious diseases and epidemiology at Monash University told SBS News plague is “classically not associated with food, but contact with an infected animal is one way to catch plague”.
Authorities warned people against eating raw marmot meat because it can carry the plague.
Some people ignored the warnings because they believe consuming the innards of the rodent is good for their health.
There are different forms of the illness, one is called the bubonic plague, which causes swelling of the lymph nodes, and another one is called the pneumonic plague, which affects the lungs.
According to the US Center for Disease Control “humans usually get plague after being bitten by a rodent flea that is carrying the plague bacterium or by handling an animal infected with the plague”.
The disease is very rare today and can be commonly treated with antibiotics.
Black Death and Quarantine
The bubonic plague, or ‘Black Death’ of the 14th century, killed a quarter of Europe’s population, with smaller epidemics occurring until 1720.
Images of quarantined towns or villages affected by the bubonic plague are part of many history books.
The plague, or Black Death, claimed millions of lives in the Middle Ages. Source: AFP
But Dr Cheng told SBS News it’s not commonly done today.
“The concept of quarantine comes from the plague back in the old days and it’s a bit unusual in this day and age to quarantine places.
“We have effective antibiotics that we generally give them, which is probably a more effective method of control.”
“There might be good reasons to do it, but it seems unusual in this day and age,” Dr Cheng said.
Associate Professor Simon Reid, from the School of Public Health at the University of Queensland agreed.
“They may have protocols that they put in place that are part of their policies around quarantine. Quarantines are quite an extreme or unusual thing for a health department to do,” he told SBS News.
There’s some controversy why the Black Death that ravaged through Europe and other parts of the world was so deadly.
The traditional thinking was that it was spread by rodent fleas that carried the bacterium.
A plague doctor's mask was commonly used in the Middle Ages. Source: Getty
But some experts proposed that there may have been additional ways of transmission, such as through body lice or food, for example, because it spread so quickly.
Dr Cheng said isolating people seemed a good idea in the Middle Ages.
“The rationale for quarantine was that there weren’t any other control measures, back then there were no antibiotics or other treatments, so really the only way to stop it transmitting was to try and isolate people in the hope that that would prevent any onward spread,” Dr Cheng said.
Professor Reid said that the biggest difference between then and now is context.
“In Mongolia, you have a wild rodent reservoir, so you look at how people interact with the environment of that rodent and it’s not an intimate relationship,” he told SBS News.
“In Europe, you had over-crowded cities with very poor hygiene, very poor sanitation and a large number of rodents, rats and mice, they had poor nutrition, they didn’t have a good immune system, there was no treatment, no antibiotics, no understanding of transmission,” he said.
Cases today
Cases of plague nowadays are very rare and are usually treated with antibiotics.
Most of the cases found today are in Madagascar, parts of South Asia, and Mongolia.
There are also rare cases in the western United States, where it’s usually transmitted by prairie dogs.
Dr Cheng explained that in the US and most other places “the modern control is to find cases and treat them”.
“In modern times, the transmission is different, we do not have big epidemics,” he said.
Could the plague arrive in Australia?
It’s very unlikely that the plague would arrive in Australia. The last cases here were in 1925.
“The plague doesn’t occur here and we have antibiotics so it’s unlikely a person would remain untreated [should it arrive here]” Professor Reid said.
But the experts agree that it’s not possible to eradicate the plague globally, as it is so widespread in rodents.
