THE WORLD Health Organisation (WHO) has reported the deaths of 61 diamond miners in the Democratic Republic of the Congo from pneumonic plague, which ravaged Middle Ages Europe as 'the Black Death'. Today 98.7% of the three types of plague cases are found in Africa: worldwide, in 2003, nine countries reported 2,118 cases and 182 deaths, also in the ex-USSR, the Americas and Asia. Pneumonic is the rarest strain, with around 2% of cases, compared with bubonic and septicaemic plague. It is the deadliest, transmitted human-to-human by breath droplets from victims with advanced infections of bubonic plague, caught from infected fleas. This outbreak was generated by "very unsanitary" conditions at the crowded open mine, of 7,000 miners. The disease broke out on December 20, just four days after the mine had been reopened. Around two-thirds of the miners later fled towards surrounding villages, pursued by Congolese health workers administering chemo-prophylaxis to prevent secondary outbreaks. Some died in the jungle though, as the disease can kill in two days. Victims generate a cough, fever, and discomfort within 2-6 days of infection, being killed by fluid-filled lungs.