Well, we had a good run while it lasted. It looks like the plague–yep, the same deadly disease that decimated Europe's population during the Middle Ages–might be back.
Last summer, a 42-year-old man showed up at a rural Colorado hospital complaining of fever, chest and muscle pain, and blood-tinged mucus, according to a new case report from the New England Journal of Medicine.
At first, doctors thought he was suffering from a particularly bad case of pneumonia. But when they found out that his dog had recently gotten sick and died–and had likely been exposed to flea-harboring prairie dogs–they got the idea to test him for pneumonic plague. Bingo.
This scare prompted the Centers for Disease Control and Prevention (CDC) to issue a report last month reminding doctors that the plague is still out there.
(Will you get the disease so devastating that people used to call it BLACK DEATH? No. Probably not. You're way more likely to develop one of these 10 Diseases Most Guys Will Have by Age 50.)
But since Men's Health didn't exist in the 14th century, there isn't a handy guide for how to handle the plague. So here's a quick run-through for the worst-case scenario:
There are three types of plague: bubonic, septicemic, and pneumonic. All are bacterial illnesses caused by a specific bug called Yersinia pestis, which are harbored by fleas. You can contract it if an infected flea bites you, or if another animal they bite scratches or bites you, too.
Expect flu-like symptoms when you're first infected. People with bubonic plague develop swollen, painful, and tender nodes called buboes in the groin, armpit, or neck. With septicemic plague, you would experience abdominal pain, shock, and blackened skin on your fingers or toes caused by dead tissue.
Pneumonic plague, on the other hand, is a lot harder to pinpoint. It comes with coughing, chest pain, shortness of breath, and watery or bloody mucus–as a lot of other more common diseases do, too.
“It can be quite hard to distinguish from regular pneumonia,” says infectious disease specialist Kristine Erlandson, Ph.D., who coauthored the NEJM case report.
The good news, of course, is that any kind of plague is super rare. Less than 1,000 U.S. plague cases were confirmed between 1900 and 2010. And in the last four or five decades, an average of 7 people have been diagnosed per year.
For comparison, from 2009 to 2013, more than 20 people died each year after some unfortunate encounters with lightning, according to the CDC.
Related: The 5 Fastest Ways That Men Die.
Still, you might want to be a little extra cautious if you live in southwestern states like Colorado, Arizona, California, or New Mexico, where most U.S. plague cases occur. (Experts aren't exactly sure why, but it seems like the plague-causing bacteria is mostly confined to that area, says Erlandson).
Avoid playing with or feeding wildlife like squirrels, rodents, or prairie dogs. And use flea repellant when hiking or camping, as well as on any outdoor dogs and cats.
And if you do happen to come down with weird flu or pneumonia-like symptoms? Consider those common illnesses first. Because again, it's probably not the plague.
But if you know that you've been exposed to fleas or animals that might carry an infection–and especially if you're developing tell-tale buboes or blackened skin–call your doctor. Immediately.