The plague never went away: what to know

TThe plague looks like something out of a history book. But the disease – nicknamed the “Black Death” or “Great Pestilence” – that killed more than 25 million people, around a third of Europe, in medieval times, is still with us today.

Colorado officials confirmed Tuesday one human case of the plague was detected in Pueblo County. This comes after another human case in Oregon in February.

Caused by bacteria Yersinia pestiswhich is often carried by fleas and spread by small animals like rodents or cats, the plague has been responsible for more than 200 million deaths throughout history, dating back to 3,800 years ago, according to an article published in American Journal of Medicine. Although most casualties occurred during three major pandemics – in the 6th century in and around Constantinople, in 14th century Europe and in 19th century Asia – outbreaks have persisted to this day.

O US Centers for Disease Control and Prevention says that an average of seven cases are reported in the country each year, mainly in the western and southwestern states. Globally, there are around 1,000–3,000 cases per year, with the three most endemic countries being the Democratic Republic of Congo, Madagascar and Peru, according to the World Health Organization.

There are two main forms of plague infection: bubonic, which is caused by flea bites or blood contact with another animal or infected material and is characterized by swollen lymph nodes or “buboes”; and pneumonic, a serious lung infection caused by inhaling droplets, such as coughing from infected humans or cats. More than 80 percent of plague cases in the U.S. have been the bubonic form, according to the CDC, although the pneumonic form is more dangerous.

There is currently no vaccine that can prevent plague infection available in the U.S., although there are steps you can follow, including using insect repellent and applying flea products to pets, to reduce the risk of infection. Today, however, most cases of plague do not result in death due to advances in treatment, including with commonly available antibiotics – although untreated cases can be fatal. The overall risk of death for all types of plague in the U.S., according to Mayo clinicis around 11%.

The most important factor for survival is that medical care begins immediately. Symptoms to watch for include swollen lymph nodes, sudden fever, headaches and body aches, weakness, vomiting and nausea, shortness of breath, chest pain, and coughing, especially with bloody mucus.