Isolated Cases of Plague — Inner Mongolia-Beijing, 2019

What is already known about this topic? Plague is an acute infectious disease caused by Yersinia pestis (Y . pestis) and is primarily transmitted by rodents. Human can be infected by bites of bacterium-bearing fleas or direct contact with diseased or dead plague-infected animals. In 2004, the last human plague case was reported in Inner Mongolia Autonomous Region due to skinning a dead hare. What is added by this report? This is the first case of pneumonic plague imported into a major city since the founding of the People's Republic of China. Two primary pneumonic plague cases (Patients A and B) found in residents of Inner Mongolia were confirmed in Beijing on November 12, 2019. Another case (Patient C) of Y. pestis was identified as bubonic plague on November 14. Patient A most likely became infected from aerosol exposure to infective droplets while digging on his farm, located in an Meriones unguiculatus (M. unguiculatus) natural plague focus. Patient B became infected from contact with Patient A (her husband). Patient C became infected after skinning a dead hare. There was no epidemiological relationship between the Patient A/B and Patient C. What are the implications for public health practice? When epizootic plague is detected, local health-care providers and the public should be alerted about any possible risks. Public education efforts should focus on promoting personal protection measures.