A middle-aged couple in China “was diagnosed with pneumonic plague, a highly infectious disease similar to bubonic plague, which ravaged Europe in the middle ages”.

CNN reports: “This is the second time the disease has been confirmed in the region this year.

“The first time was in May when a Mongolian couple died from bubonic plague after eating a raw kidney from a marmot. That triggered a six-day quarantine in the area, according to The Guardian.

“The two newest cases came from Inner Mongolia, a sparsely populated province in northern China, and were diagnosed in Beijing where the patients are receiving treatment.”

Caused by the bacterium Yershinia pestis the plague can arise in three forms – “a lung infection, known as pneumonic plague; a blood infection, known as septicemic plague; and a form that affects the lymph nodes, called bubonic plague”.

“The last of those forms is perhaps the most famous, and was behind several pandemics including the Black Death of the late middle ages, which is estimated to have killed up to 60 percent of the European population.”

Chinese government officials “warned citizens to take precautions to protect themselves from a potential outbreak, though it did say that there was no reason to panic and the risk of transmission was extremely low, as the New York Times reported”.

It was also noted that “the Chinese Center for Disease Control and Prevention responded quickly to the cases, quarantined the patients, did an investigation into people who could have been exposed to the bacteria and disinfected all relevant sites”.

“They also ramped up their monitoring of all patients with fevers,” the report added.

“However, South Korea press affiliates have followed rumors on Chinese social media that the Chinese government is downplaying the scope of the disease and many more people are actually exposed and infected, as the UPI reports.

“Pneumonic plague, which the two patients in China have, is always fatal if it is not treated quickly with antibiotics.”

According to the UPI: “Plague is caused by a bacterium, Yersinia pestis, which typically takes two to six days after exposure to manifest as an infection. However, in the case of pneumonic plague, which the two new patients have, someone exposed to the bacterium through the air will usually become ill within one to three days.”

Bubonic plague is notable for a pandemic that “killed an estimated 60 percent of Europe’s population in the late middle ages”.

“However, pneumonic plague is far more virulent and deadly than bubonic plague, according to The Guardian.

“In the case of bubonic plague, the disease is transmitted when people handle an infected animal or when an infected flea bites people. Pneumonic plague is airborne and can be spread when an infected person coughs, according to the US Centers for Disease Control.

“Despite China’s assurance that the risk of exposure is extremely low, fears are mounting that an outbreak of the pandemic will take root and residents are wondering why it took the authorities so long to announce the diagnosis.”

It was also reported that “Chinese censors mandated news aggregators to ‘block and contro'” online discussions related to plague”.

“That order prompted citizens to call for transparency since China has ignominious track record of covering up diseases.”

The report concluded: “What’s even scarier is the information not being made public.”