A 15-year-old herder has died in Kyrgyzstan of bubonic plague - the first case in the country in 30 years - officials say.
The teenager appears to have been bitten by an infected flea.
The authorities have sought to calm fears of an epidemic and have quarantined more than 100 people.
Bubonic plague, known as the Black Death when it killed an estimated 25 million people in Europe during the Middle Ages, is now rare.
World Health Organisation epidemic disease expert Eric Bertherat told the BBC there were about 400 cases of bubonic plague reported in 2012.
He said Africa accounted for more than 90% of cases worldwide - especially Madagascar and the Democratic Republic of Congo.
Dr Bertherat said that bubonic plague in Central Asia was usually transmitted by fleas attached to small wild mammals, which meant that only those who lived in rural areas and worked outside for long hours were in danger of being affected.
"Because bubonic plague is such a rare event, local medical staff are not prepared to diagnose the disease and treat it appropriately," he said, "which means the first patient usually dies without even a diagnostic.
"If secondary cases occur, medical staff are aware and better able to treat patients with antibiotics."
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