As reports of bubonic plague in the Democratic Republic of Congo have filtered into neighboring Uganda, the Ugandan government is taking preemptive action, according to Uganda's Daily Monitor and reported by ProMED-mail.

The Ugandan Ministry of Health has announced a plague prevention program, including spraying pesticides throughout the Arua and Nebbi districts, which have combined populations of more than one million people. The pesticide of choice, Icon, is aimed at killing fleas and mosquitoes, which can spread the disease. Earlier this year in the U.S., the pesticide was blamed in a class-action lawsuit in Louisiana for poisoning local animals, and a 2007 endorsement of Icon for combating mosquito-spread malaria led environmental advocacy groups to warn that the insecticide may harm human health and fertility. 

Concerns about the plague, however, appear to outweigh those about the pesticide. Caused by bacteria (Yersinia pestis), the bubonic plague is spread by biting insects that are frequently carried by common rodents and other animals. Although the disease—known in the Middle Ages as Black Death—is highly pathogenic, its fatality rate (upward of 50 percent if untreated) can be greatly reduced if detected and treated early. Last year, the plague killed 17 people in the northwestern region of Uganda and infected 90 others. Worldwide, more than 2,000 people were infected by the plague in 2003, the last year for which the World Health Organization has reported data. In the U.S., however, fewer than 15 cases of plague are typically reported each year, according to the U.S. Centers for Disease Control.

Last month, authorities in China reported cases of pneumonic plague, which is a more deadly, respiratory disease also caused by Y. pestis, the Guardian reported. After quarantining a town in the Qinghai province, the outbreak appears to have subsided.

Image of characteristic plague buboes courtesy of Wikimedia Commons/CDC