AUTHOR=Xi Jinxiao , Duan Ran , He Zhaokai , Meng Lei , Xu Daqin , Chen Yuhuang , Liang Junrong , Fu Guoming , Wang Li , Chun Hua , Qin Shuai , Lv Dongyue , Mu Hui , Tang Deming , Wu Weiwei , Xiao Meng , Jing Huaiqi , Wang Xin 

TITLE=First Case Report of Human Plague Caused by Excavation, Skinning, and Eating of a Hibernating Marmot (Marmota himalayana)

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.910872

DOI=10.3389/fpubh.2022.910872

ISSN=2296-2565

ABSTRACT=ABSTRACT
Introduction: The Qinghai-Tibet Plateau is considered the most plague-heavy region in China, and skinning and eating marmots (Marmota himalayana) is understood to be the main exposure factor to plague. Yersinia pestis is relatively inactive during marmots’ hibernation period. However, this case report shows plague infection risk is not reduced but rather increased during the marmot hibernation period, if plague exposure is not brought under control.
Case presentation: The patient was a 45-year-old man who presented with high fever, swelling of the axillary lymph nodes and existing hand wounds on his right side; Y. pestis was isolated from his blood and lymphatic fluid. Hence, the patient was diagnosed with a confirmed case of bubonic plague. Later, his condition progressed to the septicemic plague. Plague exposure through wounds and delays in appropriate treatment might have contributed to plague progression.
Conclusions: This case report reveals that excavating a hibernating marmot is a significant transmission route of plague. Plague prevention and control measures are priority needs during the marmot hibernation period.