A New Mexico man died after being hospitalized for bubonic plague in the state’s first death from the disease since 2020, health officials reported.

“We extend our deepest sympathy to the family of the Lincoln County man who succumbed to plague ,” State Public Health Veterinarian Erin Phipps said in a Friday, March 8, news release.

“This tragic incident serves as a clear reminder of the threat posed by this ancient disease and emphasizes the need for heightened community awareness and proactive measures to prevent its spread,” Phipps said.

The last human plague case in New Mexico involved a Torrance County resident in 2021, the agency said. Four people in the state had bubonic plague in 2020 and one died.

Here’s what to know.

What is bubonic plague?

Bubonic plague is caused by a bacteria named Yersinia pestis and is often spread by fleas on rodents and squirrels, the Centers for Disease Control and Prevention said.

Humans can catch plague by being bitten by infected fleas or by close contact with an infected animal, the agency said.

What was the Black Death?

Bubonic plague killed millions of people in Europe and Asia during the Middle Ages, when it was called the Black Death, according to History.com .

It became known as the Black Death for the black blotches caused by internal bleeding, the National Institutes of Health said.

The plague arrived in Europe in the 1300s when trading ships filled with sickened sailors docked in Messina on Sicily, History.com said.

Some people thought the Black Death, which could kill a healthy person overnight, was a punishment from God, according to the site.

The pandemic, which some people say inspired the nursery rhyme “Ring Around the Rosy,” finally petered out by the 1350s, in part because cities began quarantining newly arrived sailors, the site said.

What are the symptoms of bubonic plague?

Symptoms of plague can include a sudden onset of fever, nausea, weakness, chills, muscle aches and swollen lymph nodes, Deschutes County health officials said.

Symptoms typically begin within two to eight days of exposure, officials said.

How is bubonic plague treated?

Antibiotics are used to effectively treat plague, but the disease can still cause serious illness or death if untreated, the CDC said.

How can you avoid bubonic plague?

Plague cases among humans in the United States mostly occur in rural areas of the western U.S., but the disease is more common in parts of Africa and Asia, the CDC said.

Health officials advise people to avoid contact with rodents and fleas, prevent pets from approaching sick or dead rodents and keep rodents out of their homes.

The New Mexico Department of Health also advised keeping food and water bowls for pets away from wildlife, keeping hay, wood and compost piles away from homes and having ill pets examined promptly by a veterinarian.