According to Ariuntuya Ochirpurev with the World Health Organization (WHO), the couple had eaten raw marmot meat and kidney, thought to be a folk remedy for good health.
The quarantine was imposed due to suspicion that the couple developed pneumonic plague, a form of the disease that can be transmitted person-to-person.
More than 100 contacts were given antibiotic prophylaxis.
Can plague be transmitted via foodborne transmission?
Plague is most often caused by the bite of Yersinia pestis-infected fleas, and that fact caused some to question the mode of transmission reported–consuming raw marmot meat (Marmots are a known carrier of the plague bacterium).
Several commenters on social media either didn’t know of the possibility or it caused skepticism:
One person wrote: And so many unusual or atypical aspects been reported here. I had never heard of GI as a transmission route for plague before, but apparently there is data on cases transmitted via that route in the archives. Very surprising to me, all the way around. But then that meat source, well, another surprise to say the least.
Another said: I’m very skeptical that the plague bacterium was transmitted from consumption from my personal work with zoonotic disease over my 25y career. Flea bites, handling the carcass of rodents, or if pneumonic – person to person via respiratory route.
While clearly not common, foodborne transmission has been documented. Here are three papers documenting its occurrence:
One study showed that human plague with pharyngeal and gastrointestinal symptoms can result from eating infected raw camel liver.
Another paper reports a pharyngeal plague outbreak linked to the consumption of camel meat.
Lastly, a study looked at an outbreak of acute gastroenteritis occurred in Nimroz Province of southern Afghanistan. Confirmatory testing using real-time PCR and immunological seroconversion of one of the patients confirmed that the outbreak was caused by plague, with a rare gastrointestinal presentation.
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