Forbes.com

Topline: One of the deadliest pandemics in human history, the Black Death plague, has cropped up again with two cases recently reported in China—although chances of another global pandemic are slim to none, according to medical experts.

• Two people from the Chinese province of Inner Mongolia are reportedly being treated for the plague—the same disease that caused the Black Death, which wiped out around 50 million people in Europe during the 14th century—according to state officials.
• It’s not the first time the disease has been reported this year: Earlier in 2019, a Mongolian couple died from bubonic plague after eating a raw marmot kidney, while over the summer, plague-infested prairie dogs shut down parts of a Denver suburb in Colorado.
• Human infections continue to occur primarily in rural areas, sometimes in the western U.S., but more frequently in parts of Asia, South America and primarily Africa, according to the Centers for Disease Control and Prevention. 
• In recent decades, an average of seven human plague cases in the U.S. have been reported each year, with the last deaths occurring in 2015, according to CDC data.
• Plague can be transmitted through flea bites and infected animals, primarily wild rodents like rats, prairie dogs, squirrels and rabbits—although human pets like cats and dogs can also get infected.
• While today we have modern antibiotics to effectively treat infections and prevent death if caught early enough, there is currently no vaccine to protect individuals from the plague.

Crucial quote: “The risks of a global plague pandemic such as the 14th century Black Death are close to nil,” says Dr. James Shepherd, an associate professor of internal medicine (infectious diseases) at the Yale School of Medicine. “It is a zoonosis—an infection with a wild animal reservoir—transmitted by flea bites and so it doesn’t have the capacity to rapidly spread from person to person. … There are sporadic cases in the U.S. annually, often in hunters, so we see it occasionally.”

Key background: During the Middle Ages, the Black Death plague wiped out around 50 million people. Plague is caused by the bacterium Yersinia pestis, and can arise in three forms: Bubonic plague is most common, marked by swollen lymph nodes on the body. If not treated early enough, that can cause septicemic plague, which infects the blood, and worse yet, pneumonic plague, which infects the lungs.

What to watch for: Despite its associations with historical pandemics, the disease is still around today. More than 3,248 cases were reported worldwide from 2010 to 2015, including 584 deaths, according to the World Health Organization. With close to 50,000 human cases of the plague in the last two decades, according to CNN, the WHO now classifies it as a reemerging disease. The three countries where the plague is most endemic are Peru, the Democratic Republic of the Congo and Madagascar—where a 2017 outbreak saw 2,348 reported cases and 202 deaths.