A child in Elmore County, Idaho has contracted the plague according to the state health officials. While the plague has been diagnosed in squirrels as recently as 2016, this marks the first human transmission in Idaho in over a quarter-century according to the Central District Health Department.

The child, whose age and sex are unknown, is currently recovering while receiving antibiotic treatment.

Officials are unsure whether the child contracted the plague at home in Idaho or during a recent trip to Oregon - where there have been eight human cases of plague since 1990 vs. two in Idaho.

Plague epidemics have occurred in Africa, Asia, and South America but most human cases since the 1990s have occurred in Africa. Almost all of the cases reported in the last 20 years have occurred among people living in small towns and villages or agricultural areas rather than in larger towns and cities. -CDC

“Plague is spread to humans through a bite from an infected flea. People can decrease their risk by treating their pets for fleas and avoiding contact with wildlife,” Sarah Correll, a Central District Health Department epidemiologist, said in a statement. “Wear insect repellant, long pants and socks when visiting plague affected areas.”

The symptoms of plague typically appear within two to six days of exposure, and include sudden fever, chills, headache and weakness. There is typically a painful swelling of the lymph nodes in the armpit, groin or neck.

Plague symptoms in animals include fever, loss of appetite and lethargy - along with swollen lymph nodes under the jaw. Prompt diagnosis and immediate antibiotic treatment can greatly reduce the risk of death in both people and pets.

According to the CDC:

Plague was first introduced into the United States in 1900, by rat–infested steamships that had sailed from affected areas, mostly from Asia. Epidemics occurred in port cities. The last urban plague epidemic in the United States occurred in Los Angeles from 1924 through 1925.

Plague then spread from urban rats to rural rodent species, and became entrenched in many areas of the western United States. Since that time, plague has occurred as scattered cases in rural areas. Most human cases in the United States occur in two regions:

Northern New Mexico, northern Arizona, and southern Colorado

California, southern Oregon, and far western Nevada

Over 80% of United States plague cases have been the bubonic form. In recent decades, an average of seven human plague cases have been reported each year (range: 1–17 cases per year). Plague has occurred in people of all ages (infants up to age 96), though 50% of cases occur in people ages 12–45. It occurs in both men and women, though historically is slightly more common among men, probably because of increased outdoor activities that put them at higher risk.