Health authorities in Inner Mongolia, China, diagnosed two cases of the bubonic plague, the medieval disease sometimes known as “the black death,” state media confirmed on Sunday.

According to local health officials, the confirmed cases are of a 27-year-old man and his 17-year-old brother, currently being treated at two separate hospitals. The pair are said to have contracted the illness after consuming rodent meat.

On Sunday, the city of Bayannur announced a level three warning of plague prevention and control, now in place through the end of 2020. Local authorities are urging people to take extra precautions to reduce the risk of human-to-human transmission as well as to refrain from hunting or eating rodents liable to cause infection.

“At present, there is a risk of a human plague epidemic spreading in this city,” the local authority said. “The public should improve its self-protection awareness and ability, and report abnormal health conditions promptly.”

As noted by the Center for Disease Control (CDC), the bubonic plague is an infectious disease that “affects rodents, certain other animals, and humans.” They describe its symptoms in further detail:

Patients develop sudden onset of fever, headache, chills, and weakness and one or more swollen, tender and painful lymph nodes (called buboes). This form is usually the result of an infected flea bite. The bacteria multiply in the lymph node closest to where the bacteria entered the human body. If the patient is not treated with appropriate antibiotics, the bacteria can spread to other parts of the body.

The bubonic plague became known as the “Black Death” in the Middle Ages when between 75 to 200 million people across Eurasia and North Africa died from the disease. It can currently be treated by antibiotics if administered within a certain time frame.

A few cases of bubonic plague occur every year in modern times, particularly in Mongolia and northern China. In May 2019, a Mongolian couple died after similarly eating the raw kidney of a marmot, which some communities believe is a folk remedy for good health. Months later, two more people in Inner Mongolia were infected with the pneumonic plague, a different variant of the disease that affects the lungs. They eventually recovered from the disease.

It remains highly unlikely that the cases will lead to an epidemic similar to the Chinese coronavirus that has brought large parts of the world to an effective standstill this year.

“Unlike in the 14th Century, we now have an understanding of how this disease is transmitted,” Dr. Shanti Kappagoda, an infectious diseases doctor at Stanford Health Care, previously told news site Healthline. “We know how to prevent it. We are also able to treat patients who are infected with effective antibiotics.”

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