An outbreak of plague in northwest China that killed eight villagers is reportedly now under control.

Nineteen plague cases were reported across four counties in the central and eastern parts of Qinghai Province between October 4 and 9, said a Ministry of Health spokesman yesterday, but no outbreaks had been detected in other areas.

A circular issued by the provincial health bureau on Wednesday said that the 11 who survived have all fully recovered.

The majority of the infected were farmers and herdsmen who had caught the disease after killing or eating wild marmots, says the circular. However, the cause of several cases in Nangqen County is still under investigation.

The counties of Ulan, Huangyuan and Madoi have lifted their quarantines, and Nangqen is expected to come out of isolation soon.

After the outbreak, the Ministry of Health sent a team to affected areas to offer medical guidance, said the spokesman.

The Qinghai Provincial Health Bureau also took a series of measures to distribute medicine and curb the spread of the disease, as well as strengthening supervision of the marmot market.

Marmots are related to gophers and prairie dogs and live in the grasslands of China's northwestern regions and Mongolia, where villagers often hunt them for meat. The strain of bubonic plague that occurs amongst marmots is generally thought to be the most virulent.

Previously, in late August, the Ministry of Health had reported two plague cases, including one death, in Qinghai and neighboring Gansu Province.

Plague describes three main clinical forms of disease caused by the bacterium Yersinia pestis: bubonic, septicaemic and pneumonic plague. They are transmitted by fleas from infected rats or from infected blood or tissue and, in the case of pneumonic plague, close person-to-person contact.

Bubonic plague, the most common form, can cause high fever, delirium and swollen lymph nodes and is fatal in 50 to 60 percent of cases without timely treatment. The other two forms are invariably fatal if untreated.

The ministry spokesman said some grassroots medical workers are not aware enough of the importance of plague prevention and control but that they have ordered local health authorities to improve monitoring systems and draw up an emergency plan against outbreaks.

Cases of rats and marmots dying of plague, suspected plague patients and cases of high-fever without a known cause must all be reported to the ministry immediately, said the spokesman.

(China Daily October 29, 2004)