Pneumonic Plague Fatality in Arizona Highlights Ongoing Health Risks

A recent death in Arizona marks the first recorded fatality from pneumonic plague in the United States in nearly two decades, according to local health officials. This incident underscores that while plague may seem like a relic of the past, it remains a relevant health concern today, particularly in certain regions where it is endemic.

Plague, caused by the bacterium *Yersinia pestis*, has three primary forms: bubonic, septicemic, and pneumonic. As explained by Dr. Thomas Jeffries, Senior Lecturer in Microbiology at Western Sydney University, "Bubonic plague, characterized by swollen lymph nodes, is the most common form and is typically spread via fleas that infest animals such as rats and prairie dogs. However, pneumonic plague is considered the most severe and can be transmitted through respiratory droplets from person to person."

The recent fatality, reported on July 15, 2025, comes at a time when plague cases in the U.S. average about seven annually, primarily in the western states where it is endemic among wildlife populations. According to the Centers for Disease Control and Prevention (CDC), there have only been 14 plague-related deaths recorded in the past 25 years, emphasizing the rarity of such events. However, the pneumonic form's fatality rate can reach up to 100% if untreated, as noted by Dr. Jeffries.

Historically, plague has caused significant mortality, with the Plague of Justinian and the Black Death leading to millions of deaths across Europe and Asia. The third plague pandemic, which lasted from 1855 to around 1960, saw approximately 12 million deaths, mainly in India, highlighting the disease's devastating potential.

In modern times, while the U.S. has not experienced a major outbreak in a century, the recent death raises concerns about the potential for pneumonic plague to spread more broadly. Dr. Sarah Johnson, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, stated, "Although the bacterium is not present in Australian wildlife, global health experts must remain vigilant, especially considering the influence of climate change on wildlife habitats and disease transmission."

Plague can be effectively treated with antibiotics if caught early; however, the recent case's severity serves as a reminder of the disease's potential risks. As Dr. Jeffries cautioned, "Public health systems must continue to monitor for plague and educate communities, particularly in rural areas, about the risks and symptoms associated with this disease."

As the global landscape changes with climate influences and urbanization, the possibility of diseases like plague re-emerging or spreading to new areas becomes more pronounced. Recent data from the World Health Organization indicates that countries such as the Democratic Republic of the Congo, Madagascar, and Peru still report a significant number of plague cases, with the disease primarily affecting rural, agricultural populations.

In conclusion, while the pneumonic plague death in Arizona may be an isolated incident, it serves as a critical reminder of the ongoing health threats posed by historical diseases. Continued public health vigilance and research are essential to mitigate risks and respond effectively should similar cases arise in the future.