An Arizona resident has died from pneumonic plague — the first such death in nearly two decades. Learn how this modern case of the ‘Black Death’ unfolded, symptoms to watch for, how it spreads, and what health officials recommend to stay safe.
In a chilling reminder of history’s deadliest pandemic, Arizona health officials have confirmed that a resident has died after contracting pneumonic plague — a severe and highly infectious form of the disease known historically as the “Black Death.” This is the first reported plague-related death in Arizona’s Coconino County in nearly two decades, reigniting public concern over the rare but serious bacterial infection.
A Fatal Encounter with a Historic Illness
On July 11, 2025, Coconino County public health authorities released an alarming statement: a patient in Northern Arizona succumbed to the pneumonic plague. The person, whose identity has not been revealed due to privacy laws, was treated at Flagstaff Medical Center’s Emergency Department. Despite medical intervention and emergency resuscitation efforts, the patient did not survive.
“This is a tragic loss for our community,” Northern Arizona Healthcare said in a public statement. “The team at NAH expresses deep condolences to the family. Out of respect for their privacy, no further details will be shared.”
This marks the first plague-related death in the county since 2007, when another person died after suspected exposure to an infected animal.
The Resurfacing of the ‘Black Death’
The illness responsible for the fatality is caused by Yersinia pestis, the same bacterium behind the Black Death that decimated Europe’s population during the Middle Ages. The strain identified in this latest case is pneumonic plague, which primarily affects the lungs and can be transmitted between humans through respiratory droplets — making it the only form of plague capable of spreading from person to person.
According to health officials, a rapid diagnostic test performed at the hospital revealed a presumptive diagnosis of plague. Follow-up testing and investigation by state and federal health agencies are ongoing.
What Is Yersinia Pestis?
Yersinia pestis is a zoonotic bacterium, which means it can be transmitted from animals to humans. It’s typically spread through bites from fleas that have fed on infected rodents such as rats, mice, or squirrels. However, certain strains like pneumonic plague can be passed from human to human through airborne droplets when a person coughs or sneezes.
Though the disease has medieval roots, modern cases continue to emerge sporadically around the world. The bacteria can still be deadly if left untreated, but with early diagnosis and antibiotics, most patients can fully recover.
Understanding the Three Forms of Plague
Plague infections present in three primary clinical forms:
1. Pneumonic Plague
This is the most dangerous and infectious type of plague. Symptoms appear quickly, often within 24 hours of exposure, and include:
- Sudden fever and chills
- Severe headache and weakness
- Chest pain and shortness of breath
- Coughing up blood or watery mucus
Unlike other forms, pneumonic plague spreads through airborne transmission, meaning it can pass from an infected person to others through droplets in the air — making outbreaks harder to contain. The recent Arizona case involved this variant.
2. Bubonic Plague
This form results from the bite of an infected flea. Its hallmark is the appearance of painful, swollen lymph nodes, called buboes, near the area of the bite. Other symptoms include:
- High fever and chills
- Headache
- Weakness and fatigue
Bubonic plague typically has an incubation period of 2 to 8 days. While it’s the most common form, it is not easily transmissible between people.
3. Septicemic Plague
A rarer form, septicemic plague can occur on its own or as a complication of bubonic or pneumonic plague. It causes:
- Fever and chills
- Abdominal pain
- Internal bleeding and organ failure
- Skin tissue blackening (commonly on fingers, toes, and nose)
This form can be contracted through flea bites or handling an infected animal. Without treatment, it can be fatal very rapidly.
How the Plague Spreads: Human, Animal, and Environmental Factors
While Yersinia pestis is generally transmitted through flea bites, pneumonic plague introduces a more worrisome transmission method — airborne droplets. This means that close contact with an infected individual, particularly one who is coughing, sneezing, or exhibiting respiratory symptoms, can lead to further infections.
Fortunately, according to the U.S. Centers for Disease Control and Prevention (CDC), person-to-person transmission of plague in the U.S. hasn’t been confirmed since 1924. Still, isolated cases tied to infected domestic animals — especially cats — have been reported. The CDC notes that felines are highly vulnerable to plague and may contract it by eating infected rodents, later transmitting it to humans through respiratory droplets or bites.
Who Is Most at Risk?
Although plague is rare in the United States, certain regions and individuals face a higher risk. The CDC and Cleveland Clinic highlight the following groups as being more vulnerable:
- People living in rural areas of the Western U.S.
- Veterinarians and wildlife workers
- Campers, hikers, and hunters
- Pet owners, especially in plague-prone regions
- Laboratory researchers handling plague bacteria
In recent years, most cases have occurred in African countries like the Democratic Republic of Congo, Madagascar, and Peru, where the disease is still considered endemic. However, the U.S. sees a handful of cases annually, mostly in states like Arizona, New Mexico, Colorado, and California.
Symptoms to Watch For
Prompt recognition of plague symptoms can make the difference between life and death. Since pneumonic plague progresses quickly, medical attention should be sought immediately if a person develops:
- Fever, chills, and severe fatigue
- Shortness of breath
- Painful cough with bloody mucus
- Chest pain and tightness
For bubonic and septicemic forms, additional signs may include swollen lymph nodes, darkened skin, or signs of internal bleeding. The earlier treatment is started, the better the prognosis.
One person is dead, according to officials with Northern Arizona Healthcare, on the same day they showed up at Flagstaff Medical Center with symptoms of the plague. https://t.co/OHZyxFj0xZ
— FOX 5 DC (@fox5dc) July 12, 2025
Is There a Cure for Plague?
Yes — modern medicine has significantly reduced the threat of plague-related deaths. When diagnosed early, plague can be treated effectively with antibiotics such as:
- Streptomycin
- Gentamicin
- Doxycycline
- Ciprofloxacin
The key, however, is early detection. Once the disease reaches an advanced stage, especially in cases of pneumonic plague, the effectiveness of treatment diminishes quickly.
What About Vaccines?
At present, there is no commercially available vaccine for plague in the United States. The CDC has confirmed that while several vaccines are in development, none are approved for general use as of 2025. The World Health Organization (WHO) recommends vaccinations only for high-risk populations such as:
- Healthcare professionals working in endemic areas
- Laboratory workers dealing with Yersinia pestis
- Emergency responders during outbreaks
How to Stay Safe and Reduce Risk of Infection
Though plague is rare, health experts advise taking the following steps to minimize exposure — particularly in areas where plague is known to circulate among wild animals:
1. Avoid Flea Bites
- Use insect repellents containing DEET when outdoors
- Treat pets with flea prevention products
- Keep grass and brush trimmed to deter rodents
2. Limit Contact with Wild or Stray Animals
- Do not handle sick or dead animals without protective gear
- Keep pets from roaming in plague-endemic regions
- Report rodent die-offs to local authorities
3. Practice Good Hygiene
- Wear gloves when handling potentially infected animals
- Wash hands frequently, especially after outdoor activity
- Avoid close contact with individuals who have respiratory symptoms
4. Be Alert While Traveling
If visiting plague-endemic countries, follow health advisories and take proper precautions. This includes avoiding markets with live animals and seeking immediate medical attention if symptoms develop.
A Medieval Threat in a Modern World
The recent pneumonic plague death in Arizona is a sobering reminder that ancient diseases can still pose threats in today’s world. While the United States has robust healthcare and surveillance systems, vigilance remains crucial — particularly in rural and high-risk regions.
Though rare, plague remains a serious disease that demands respect, caution, and rapid response. The good news? Early treatment is available and highly effective. Public awareness, responsible pet ownership, and preventive health measures are the best tools we have to ensure the Black Death remains a history lesson, not a modern headline.
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