Plague Kills Patient in Arizona Hospital ER—First U.S. Death Since 2021

 

A patient in northern Arizona has died from pneumonic plague after arriving at Flagstaff Medical Center's emergency department with severe symptoms. Despite "appropriate initial management" and "attempts to provide life-saving resuscitation," the patient died the same day, according to Northern Arizona Healthcare officials.

Before this, the last reported plague death in the U.S. was in 2021.

This marks the first plague-related death in Coconino County since 2007, highlighting the continued presence of this ancient disease in specific regions of the United States. Coconino County Health and Human Services confirmed on Friday that the cause of death was pneumonic plague, "a severe lung infection caused by the Yersinia pestis bacterium."

Plague is extremely rare in the United States, with an average of about seven human cases reported annually and deaths being even less common. Most cases occur in rural areas of the western U.S., particularly in northern Arizona, New Mexico, and Colorado. Prompt antibiotic treatment is highly effective, which is why fatalities are now uncommon.

Despite its rarity, plague maintains a mortality rate of approximately 11% when treated, but this rises dramatically without prompt intervention.

This recent case coincided with a notable die-off of prairie dogs near Flagstaff, which often serves as an early warning sign of plague activity in an area. Prairie dogs and other rodents frequently carry infected fleas that transmit the disease to humans through bites.

Plague Symptoms

Early symptoms of plague include sudden onset of fever, headache, chills, weakness, and painful lymph nodes. Pneumonic plague specifically presents with severe respiratory symptoms including cough, chest pain, and difficulty breathing.

Treatment protocols typically involve aggressive antibiotic therapy with streptomycin, gentamicin, doxycycline, or ciprofloxacin. The CDC notes that survival rates are significantly higher when antibiotics are administered within 24 hours of symptom onset.

Public health officials are encouraging residents in affected areas to take precautionary measures:

• Report sick or dead rodents to local health departments
• Use flea control products on pets
• Avoid handling sick or dead animals
• Seek immediate medical care if symptoms develop after possible exposure

For nurses practicing in the Western United States, maintaining awareness of plague's continued presence can help ensure rapid identification and treatment of this rare but serious condition. While modern antibiotics have dramatically reduced plague's historical mortality rates, this recent death underscores that prompt recognition and intervention remain essential.

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