You probably remember the plague from a history class, somewhere between the Middle Ages and old maps of trade routes. Most of us file it away as a disease that belongs to another time. It is still here, though, in a handful of corners of the American West.
In April 2026, Apache County Public Health Services District confirmed that a resident had tested positive for plague. The person completed antibiotic treatment and recovered.
According to the local health district, it was the first confirmed case in the county since 2015, and only the fourth since 2006.
The bacterium behind plague, Yersinia pestis, still circulates in wild rodents across the western United States.
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According to the CDC, an average of five human cases are reported each year nationally. Nearly all come from two regions in the West.
One stretches across northern New Mexico, northern Arizona and southern Colorado. The other covers parts of California, southern Oregon and far western Nevada.
Over 80 percent of US cases are the bubonic form, where the infection settles in the lymph nodes, usually caught from the bite of an infected flea.
Why the Southwest keeps seeing cases
Fleas on prairie dogs, ground squirrels and other rodents are the usual carriers. When those rodents die off, the fleas look for a new host and can jump to pets, livestock or people living nearby.
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That is why cases tend to cluster around rural areas with high wild-rodent populations.
The Apache County patient recovered after prompt treatment. No one else got sick, and local public health officials said the risk to the broader community remained low.
Three warning signs to know
Bubonic plague has a short incubation period of two to eight days after a flea bite. Three signs tend to show up together, according to the CDC's signs and symptoms page.
- Sudden fever, chills and weakness
- A severe headache
- Painfully swollen lymph nodes, called buboes, usually in the groin, armpit or neck
These symptoms can look flu-like at first, which is part of what makes the illness so dangerous when it goes unrecognized.
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Why early antibiotics matter so much
Plague is treatable, but only if caught in time. The CDC says prompt treatment with the correct medications is critical to prevent complications or death.
Without antibiotics, bubonic plague has historically killed a majority of patients. With early treatment, survival is the norm.
Doctors treat it with strong antibiotics, usually gentamicin or a fluoroquinolone, given as soon as plague is suspected. The key factor in survival is time, not the specific drug.
What to do if you live in a high-risk area
The CDC's prevention advice is simple, and lines up with what Apache County urged its own residents to do after the April case.
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- Keep pets on veterinarian-recommended flea control, even indoor-outdoor cats
- Avoid handling wild rodents, their burrows or carcasses
- Clear brush, rock piles, cluttered firewood and other rodent cover from around your home
- Use DEET on skin and permethrin on clothing when hiking or camping in areas where plague circulates
- Report unusual rodent die-offs to local authorities
Anyone who develops a sudden fever within a week of a possible flea bite or wild-rodent exposure in these regions should contact a doctor and mention the exposure.
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This article is made and published by Aksel Kryhlmand, who may have used AI in the preparation.