A rare case of the plague has turned deadly in northern Arizona, where a patient died in the emergency room of Flagstaff Medical Center after contracting the disease, health officials confirmed.

According to Northern Arizona Healthcare, a Coconino County resident died on the same day they arrived at the emergency department, despite medical staff performing appropriate initial management and life-saving resuscitation.

The death has raised alarm across the region, marking the first confirmed fatality from pneumonic plague in the county since 2007. Rapid testing showed a presumptive diagnosis of Yersinia pestis, the bacterium responsible for plague, which was historically known for causing the Black Death.

“This marks the first confirmed pneumonic plague death in Coconino County since 2007, when a person contracted the disease through contact with an infected dead animal,” officials said in a statement.

The Arizona Department of Health Services has launched an investigation to determine how the patient became infected.

“While it still exists, plague is extremely rare now. Worldwide, 1,000 to 2,000 people are diagnosed with plague every year. Only about seven cases are reported in the US each year,” according to the Cleveland Clinic.

The Centers for Disease Control and Prevention (CDC) advises immediate medical care if plague is suspected, noting that early antibiotic treatment is usually effective.

The disease is typically transmitted through flea bites from infected animals, and can present in one of three forms: Bubonic (lymph nodes), Septicemic (bloodstream), and Pneumonic (lungs). The Flagstaff case involved the pneumonic form, the most dangerous type, which can spread through respiratory droplets.

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