When was the last time you worried about getting the flu? A few months? Maybe a year? How about catching the plague? It’s something the civilized world hasn’t feared in ages, but two new cases of the disease just popped up in New Mexico, raising concern that the number of yearly instances of human plague infection could be growing. 

The two new confirmed infections were both in older middle-aged women — a 52-year-old and a 62-year-old — and both are being treated and have been hospitalized. The first case of the year, according to the state’s health department, was that of a 63-year-old man. He is said to have recovered from the disease as well.

Plague was one the scourge of humanity, wiping out millions and millions of people during the Middle Ages. At the time, society had no way of dealing with the spread of the disease, and knew even less about how to prevent it. Today, the “Black Death” is still around, but it’s become more of a nuisance than a serious widespread health concern in countries with modern medical facilities.

The disease is spread largely through wildlife, and humans can become infected via either direct contact with compromised animals (typically rodents) or from the bites of infected fleas. Avoiding possibly infected animals is one thing, but preventing contact with something as small as a flea can pose a greater threat. Still, only a handful of people in the United States end up with the disease each year, and while fatalities still occur, they are typically quite rare.

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