Authorities are disinfecting the sealed-off town of Ziketan in northwest China, after a third person died of pneumonic plague. Medical staff also are killing rats, insects and fleas that can carry the disease. The local health bureau says at least nine more people are infected, mostly relatives of the first victim.
Police set up checkpoints on the roads around the farming community in Qinghai province when the outbreak was discovered on Thursday. Ziketan is an ethnically Tibetan town of 10,000 people in one of China's least populated regions.
An American student traveling in the area, who asked to remain anonymous, says drivers are accepting about $300 to take people out of the town.
"I think people are scared and actually fleeing the disease," she said.
She says most of the restaurants and Internet cafes in town are closed because people do not feel safe eating out. Many who do go out wear medical masks. Usually there are nightly traditional Tibetan dancing sessions, but those stopped at the beginning of the outbreak.
Pneumonic plague is spread by coughing and can kill victims in 24 hours.
Vivian Tan, the spokeswoman for the World Health Organization in China, says the disease is curable if treated early with antibiotics.
"I think it's important to note that this is not the first time this appeared in that region, because this bacteria is actually quite endemic in some rodents in that region," she said.
Tan says this is the first time the Chinese government officially notified the WHO of pneumonic plague cases, but there were two reported in Qinghai in 2001 and in 2004.
The American student says fliers in Mandarin and Tibetan were handed out at a public health meeting in Ziketan on Friday, and notices about the disease are posted in the center of town.
"They put up fliers that basically had pictures of the rodent on the grasslands. Everyone knew that it started with the rodent," she said. "Everyone I spoke with knew it was airborne and knew roughly the symptoms like fever, that sort of thing."
She confirms official Chinese reports that say the sealed-off town is not running out of supplies. She says about half the supermarkets are still open and seem to have enough food and water for the population.
Pneumonic plague often affects rural areas. It is closely related to bubonic plague, which killed around 25 million people worldwide in the 1300s.