Intended for healthcare professionals


Containing pneumonic plague

BMJ 2020; 368 doi: (Published 07 January 2020) Cite this as: BMJ 2020;368:l7072

Linked News

Pneumonia in China: lack of information raises concerns among Hong Kong health workers

  1. Dera Ranaivozanany, emergency physician1,
  2. Bertand Renaud, professor2,
  3. Daniel Lucey, adjunct professor3
  1. 1Hôpital Foch, Suresnes, France
  2. 2Faculté de Médecine, Université de Paris, Paris, France
  3. 3Department of Medicine-Infectious Diseases, Georgetown University Medstar Medical Center, Washington, DC, USA
  1. Correspondence to: D Lucey DRL23{at}

Lessons from two contrasting outbreaks

On 13 November 2019 two cases of plague pneumonia, caused by the bacterium Yersinia pestis, were reported at a hospital in the Chaoyang district of central Beijing.1 The two affected adults became ill in Inner Mongolia and were transferred by ambulance to Beijing with pneumonia of unknown cause.2 Given the high mortality of untreated plague pneumonia,3 and its potential for spread from person to person through respiratory droplets in this large urban setting, a high level of concern and rapid response was warranted.

Later that month, bubonic (lymph node) plague was diagnosed in two patients in Inner Mongolia,4 raising the possibility of an ongoing epidemic of plague in this autonomous region of northern China and prompting public health measures to minimise transmission.5 To put these cases in context, China reported just five cases of plague of all types between 2013 and 2018, according to the World Health Organization.3

Plague occurs …

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