Plague returns to US, patient dies of 'Black Death' in Arizona — Is the medieval disease spreading across America?

In the United States' Northern Arizona, a patient has died from a severe strain of the plague, revealed public health officials in a statement on Friday (Jul 11). As per Northern Arizona Healthcare (NAH), after a rapid diagnostic test, a "presumptive diagnosis of Yersinia pestis, the bacteria that causes the plague", was issued for the patient. Plague, often called the Black Death, is the same illness which in the Middle Ages killed millions of people in Europe. "(We) recently cared for a patient in the Flagstaff Medical Centre Emergency Department, and despite appropriate initial management and attempts to provide life-saving resuscitation, the patient did not recover," said NAH.

A resurgence of bubonic plague?

The patient, an Arizona citizen, died of pneumonic plague, a severe lung infection, Coconino County health officials said in a press release on July 11. The identity of the patient is yet to be released. Citing privacy laws, Northern Arizona Healthcare said it was unable to release information about the patient who died. "The NAH team is saddened by this loss of a community member," the agency said in a statement, adding, "Out of respect for the family, no additional information about the death will be released."

This is the first recorded death from pneumonic plague in the county in 18 years (since 2007). Back then, a person died after interacting with an infected animal.

What is Yersinia pestis?

Yersinia pestis is the bacterium that causes the potentially life-threatening illness known as the plague. The illness is spread by wild rodents (rats, mice, etc.) and other animals. It can be transmitted to humans, as it happened in the Middle Ages. Plague can be treated with antibiotics if diagnosed promptly.

What are the symptoms of plague?

Plague can take one of three forms: pneumonic, septicaemic, and bubonic. Pneumonic plague, which has been diagnosed as the cause of the North Arizona patient, causes fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucus. This type of plague can spread if a "person inhales infectious droplets coughed out by another person or animal with pneumonic plague". This is the only type of plague that can be transmitted by human-to-human contact. It has an incubation period "as short as +1 day".

As per the CDC, in bubonic plague, patients develop fever, headache, chills, and weakness and one or more swollen, painful lymph nodes (called buboes). It usually happens due to the bite of an infected flea and has an incubation period of 2 to 8 days.

Meanwhile, in septicaemic plague, patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. This can occur as the first symptom of the plague or if bubonic plague goes untreated. This also happens due to bites from infected fleas or from handling an infected animal. The incubation period, as per the CDC, "is poorly defined but likely occurs within days of exposure".