The black plague is still killing people in 2025

While you may assume the horror of the ‘black death’ is confined to history books, a man’s sudden death from the plague has changed everything.

President Donald Trump was swept into office promising to Make America Healthy Again. Now his controversial Health Secretary, Robert F Kennedy Jr, must contend with the return of the Black Death.

The plague that killed millions in Medieval Europe and Asia has claimed a life in Arizona. It’s the first fatality for the condition in that state for more than 18 years. And it’s a stark reminder that the bacteria behind the deadly disease is deeply entrenched in the US heartland.

It involved the plague’s most deadly incarnation.

“The recent death is concerning, as it involves the airborne pneumonic form of the disease, the only form that spreads easily from person to person,” says Western Sydney University microbiology expert Thomas Jeffries. “But there’s no evidence of further spread of the disease within the US at this stage.”

Only 14 people have died of plague in the US in the past 25 years.

But pneumonic plague is the most severe of the plague’s three forms. All are caused by Yersinia pestis bacteria.

The Middle Ages was a terrible time for disease. Picture: BBC

Bubonic plague presents with flu-like symptoms and swollen lymph nodes in the groin, armpit and neck. Septicaemic plague puts the body into shock and is characterised by blackening of the fingers, toes, and nose. Both are usually caused by bites from fleas carrying the bacteria, and fatality rates vary between 30 and 60 per cent.

The bubonic plague epidemic killed millions of people in the middle ages. Picture: iStock

Pneumonic plague is caused when tiny airborne droplets carry the bacteria into the lungs. There, it reproduces rapidly while attacking its host’s immune system. If left untreated, the fatality rate can be as high as 100 per cent. But modern medicine has advanced considerably since medieval times.

“Plague can evoke a very emotional reaction, as many people associate plague with the Black Death, which ravaged Europe and killed millions in the 1300s,” infectious disease expert Dr Shirin Mazumder told US media. “Although plague-related fatalities can occur, they are very uncommon, and we have highly effective antibiotic therapy to treat plague if diagnosed early.”

One person recently died from the plague in Arizona, USA. Picture: Getty Images

Historic potential

The 2020 COVID pandemic was caused when the SARS-CoV-2 virus mutated enough to find humans to be hospitable hosts. Similar mutations have emerged among Yersinia pestis strains over the centuries.

“This disease is one of the most important in history,” argues Jeffries.

“The Plague of Justinian (541–750CE) killed tens of millions of people in the western Mediterranean, heavily impacting the expansion of the Byzantine Empire.

“The medieval Black Death (1346–53) was also seismic, killing tens of millions of people and up to half of Europe’s population.

The "plague doctors" would wear long beak-type masks in the hopes they would not get ill. Picture: iStock

“The third and most recent plague pandemic spanned the years 1855 until roughly 1960, peaking in the early 1900s. It was responsible for 12 million deaths, primarily in India, and even reached Australia.”

However, the discovery that the cause was a flea-inhabiting bacterium has resulted in the disease being largely suppressed.

“As Y. pestis is not found in Australian animals, there is little risk here,” Jeffries states. “Plague has not been reported in Australia in more than a century.”

It was originally thought the plague was carried by rats. Picture: iStock

However, sporadic outbreaks persist in the Democratic Republic of the Congo, Madagascar, Peru, India, Central Asia, and the US, as the disease is entrenched in local rodent populations.

And a fresh outbreak of plague would be a severe test of Health Secretary Kennedy’s MAHA agenda.

Kennedy has a long history of supporting unsubstantiated health conspiracies.

He has argued that COVID-19 discriminated between ethnic groups. He has linked tap water to transgender children. He has claimed “miasma” (a medieval term for pollutants and bad smells) is just as deadly as viruses and bacteria.

The plague wiped out a lot of Europe's population. Picture: iStock

“Miasma theory emphasises preventing disease by fortifying the immune system through nutrition and reducing exposures to environmental toxins and stresses,” Kennedy wrote in his book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health.

Since taking office in February, the former environmental lawyer has cut thousands of jobs in his Department of Health and Human Services and shut down several advisory bodies and health programs at the Centres for Disease Control (CDC).

The disease is highly contagious. Picture: iStock

Known unknowns

“The only means to fight a plague is honesty,” Kennedy, 71, stated in The Real Anthony Fauci. But few details about the Arizona plague fatality have yet been released.

“Our hearts go out to the family and friends of the deceased. We are keeping them in our thoughts during this difficult time,” a Coconino County Board of Supervisors spokeswoman told media. “Out of respect for the family, no additional information about the death will be released”.

Mass graves were needed for all the dead during the plague epidemic. Picture: iStock

The incubation period of pneumonic plague, once it settles in the lungs, can be as little as one day. An intense course of common modern antibiotics is an effective treatment - if administered quickly.

Was the patient suffering from untreated bubonic or septicaemic plague, where the bacteria spread to the lungs?

Or was it contracted from infectious droplets coughed up by an animal or a person?

And was it caught in the countryside, or an urban environment?

“Plague infects an average of seven people a year in the west of the country (United States), due to being endemic in groundhog and prairie dog populations there,” writes Jeffries. “The last major outbreak was 100 years ago.”

The plague is still around after all these years. Picture: NBC

Prairie dogs are easy targets for the fleas that carry Yersinia pestis. But they tend to die quickly once infected. As such, a sudden spate of Prairie dog deaths can be an early warning sign of an outbreak of the bacteria.

“The source of the exposure is still under investigation; however, the death is not related to a recent report of a prairie dog die-off,” the Coconino County’s health service has told US media.

But other animals regularly handled by humans can get infected. Especially cats.

They can contract the bacteria by eating infected rodents or being bitten by fleas. The CDC warns that this can then be transmitted to owners when the cat sneezes.

Jamie Seidel is a freelance writer | @jamieseidel.bsky.social