Human Plague Death Reported in Arizona — Here’s What You Need to Know

Plague cases are rare, and dying from it is rarer still, experts say. But you can take steps to protect yourself.

A resident of Coconino County, Arizona, has died from the plague, the first fatality of its kind in the county in nearly two decades, according to local health officials.

Lab tests confirmed that the patient died from pneumonic plague, a severe lung infection caused by the Yersinia pestis bacterium, Coconino County health officials said in a statement. Out of respect for the family, no additional details about the circumstances are being released.

Sharon DeWitte, PhD, an anthropology professor at the University of Colorado Boulder who has studied pneumonic plague, says that plague cases are rare and fatalities are rarer still, but these infections do happen from time to time and can quickly turn deadly when patients don’t get prompt treatment with antibiotics.

“While the recent death in Arizona is heartbreaking, it is not necessarily surprising, given that there are deaths from plague periodically in the U.S., and particularly given that the person had the pneumonic form of the disease,” Dr. DeWitte says.

An average of seven human plague cases are reported in the United States each year, and most of them occur in Arizona, New Mexico, or other Western states, according to the Centers for Disease Control and Prevention (CDC).

What Is Plague?

Plague is a disease caused by the bacterium Yersinia pestis that can infect humans and mammals. Fleas carry plague, and the disease naturally cycles through wild rodent populations.

People can be exposed through flea bites or by handling an infected animal. People can also be exposed by handling sick pets, especially cats.

Plague can be diagnosed with a simple blood test and treated with commonly available antibiotics. But people need to be treated quickly to prevent serious illness or death.

What Are the Symptoms of Plague?

There are three main types of plague infections, and the symptoms can vary based on which type it is:

Bubonic plague: Common symptoms are fever, headache, chills, weakness, and one or more swollen, painful lymph nodes (called buboes). Without antibiotics, the bacteria can spread to other parts of the body.

Septicemic plague: Symptoms include fever, chills, extreme weakness, abdominal pain, and shock. Skin and other tissue may turn black and die, especially on the fingers, toes, and nose. This type of plague can develop on its own or from untreated bubonic plague.

Pneumonic plague: Typical symptoms are fever, headache, weakness, shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. This type of plague can develop from untreated septicemic or bubonic plague, or when a person inhales infectious droplets coughed out by a person or animal with plague. It’s the most serious form, and it’s the only type that can spread from person to person.

What Makes Pneumonic Plague so Bad?

“Pneumonic plague is much more serious, because once plague gets into your lungs, the decline of vital functions is precipitous — there’s a shorter window of opportunity to make effective interventions,” says Monica Green, PhD, an independent plague researcher.

“Also, pneumonic plague is immediately transmissible to those in proximity to the patient, and will be equally lethal to all those individuals too,” Dr. Green says. “This is why from our historical records, we very often see whole households succumb to plague in a very short period of time.”

What sets the current plague case apart from the plague known as the black death, which swept across multiple continents in the Middle Ages, is that conditions today are less conducive to spreading this illness — and we have antibiotics today that can treat it, Green says.

How to Reduce Your Risk of Plague

People who live in areas where plague occurs can take several steps to reduce their risk, according to the CDC. These include:

Rodent-proof your house: Make sure rodents can’t get into your home. Clear your yard of any brush, rocks, junk, firewood, and pet food that might attract rodents.
Wear insect repellant: Apply products containing DEET to the skin and clothing when you’ll be outdoors with potential exposure to fleas.
Give pets flea collars: Use collars or other flea control products to protect pets from flea bites that could cause a plague infection.
Keep pets out of your bed: If your pets roam free outdoors in areas where plague has been reported, don’t let them sleep in your bed.

“Plague persists in wild animal populations in the West and Southwest, and humans are accidental victims of this disease, for which those animals are the primary natural hosts,” DeWitte says. Prairie dogs and ground squirrels in the Western United States are common carriers of plague, DeWitte adds.

She says that people who live in or visit the Western and Southwestern United States, where these animals live, should always take precautions against plague.

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