Two U.S. Plague Cases: Fatal in Arizona, Patient Recovering in California
Podcast Episode
Plague — one of the oldest infectious diseases in human history — has re-emerged in the United States with two recent cases, including one fatality.
Arizona Case: Patient Dies from Pneumonic Plague
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.
This marks the first plague-related death in Coconino County since 2007 and the first plague death in the U.S. since 2021.
The case coincided with a die-off of prairie dogs near Flagstaff, which often signals plague activity in the area. Rodents such as prairie dogs and squirrels carry infected fleas that can transmit the disease to humans.
California Case: What Nurses Need to Know
Meanwhile, public health officials confirmed a new plague case in California.
A South Lake Tahoe resident tested positive after being bitten by an infected flea while camping in El Dorado County. The patient is currently recovering at home under medical supervision.
“The individual is receiving medical care, and El Dorado County environmental health staff, in collaboration with California Department of Public Health (CDPH), are investigating the incident,” said Dr. Bob Hartmann, El Dorado County Public Health Officer.
This case highlights that plague remains present in California’s Sierra Nevada region, where wild rodents and fleas can harbor Yersinia pestis.
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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