A patient in the United States has been struck down by the black death after they were reportedly bitten by an infected flea.
The unnamed victim was walking their dog when they were believed to have been bitten by the insect, and shortly afterwards tested positive for the bubonic plague.
Health officials in South Lake Tahoe, California, say it is thought to be the first case of the deadly disease in the state in the past five years.
Officials in El Dorado County were notified by the California Department of Public Health (CDPH) that a resident in South Lake Tahoe, 154 miles northeast of San Francisco, had tested positive.
It is thought the person, who is an avid walker, may have been bitten by an infected flea while walking their dog along the Truckee River Corridor, according to a statement released by El Dorado County.
The patient who tested positive for the plague is currently under the care of medical professionals and is still recovering at home.
El Dorado County's Health and Human Services said, once transmitted, symptoms of the plague usually surface within two weeks of exposure to an infected animal or flea.
The symptoms include fever, nausea, weakness and swollen lymph nodes.
It can be deadly, but if it is detected early it can be effectively treated with antibiotics.
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"Plague is naturally present in many parts of California, including higher elevation areas of El Dorado County," Public Health Officer Dr Nancy Williams told ABC News.
"It's important that individuals take precautions for themselves and their pets when outdoors, especially while walking, hiking and/or camping in areas where wild rodents are present.
"Human cases of plague are extremely rare but can be very serious."
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From 2016 to 2019, authorities discovered a total of 20 rodents with evidence of exposure to the plague in the South Lake Tahoe area.
"The last reported cases of plague in California were two human cases which were exposed to infected rodents or their fleas in Yosemite National Park in 2015," the El Dorado County Health and Human Services said in a statement.
"Both people were treated and recovered. These were the first reported human cases in the state since 2006."
Since the announcement of the infection, signs have appeared in the area warning the public.
Signs also tell people how to avoid the plague, including not feeding wild animals, not touching dead or sick animals, protecting your pets with flea control products, not wearing shorts and using insect repellent.
Just last month, public health officials announced a squirrel in Colorado had tested positive for the black death, the first such instance of the disease in the state this year.
"Plague is an infectious disease caused by the bacteria Yersinia pestis, and can be contracted by humans and household animals if proper precautions are not taken," officials from Jefferson County Public Health (JCPH) in Colorado said in a public statement released at the time.
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