Primary case of human pneumonic plague occurring in a Himalayan marmot natural focus area Gansu Province, China

•The patient died of primary pneumonic plague caused by contact with a dog that had captured an infected marmot.•All contacts underwent on-site isolation at home or in the hospital, and all were kept under medical observation and took prophylactic medication.•Three of the 151 contacts had F1 antibody without clinical symptoms; no secondary cases occurred.•All dogs that ate the marmot were infected with Yersinia pestis without symptoms.

SummaryA case of primary pneumonic plague (PPP) caused by Yersinia pestis is reported. This case occurred in the largest plague area in China. The patient died after contact with a dog that had captured an infected marmot. Three of 151 contacts were shown to be positive for antibody against F1 antigen by indirect hemagglutination assay, but none had clinical symptoms. There was no secondary case.