One day in 1949, a 9-year-old boy and his brother went rabbit hunting near Cerro in Taos County. Failing to catch any rabbits, on their way back home, the pair of boys noticed a prairie dog - at last, an easy target. The older brother killed the prairie dog by smashing its head open with a rock. "Only a sick prairie dog could be caught in this fashion," Taos doctor Ashley Pond III wrote ominously in his 1983 account of the incident.

The older brother carried his prize, the killed prairie dog, home. Nothing befell the older brother. The 9-year-old boy, however, fell ill the next day. The boy was brought to Pond's Taos office, where he was examined. The youngster had what appeared to be an infected blister on his left hand. He also exhibited swelling of the axillary lymph nodes, which are located in the breast.

That night, the boy's conditioned severely worsened. He was brought to Holy Cross Hospital in Taos and was admitted to the emergency room with a fever of 105 degrees Fahrenheit.

"The boy appeared very sick and the thought of plague entered in my mind," Pond wrote. This was shocking to the doctor. If his suspicions were correct, this signaled the first time human plague was ever witnessed in New Mexico. Despite his dismay, the physician had long anticipated that the plague would eventually arrive.

Today, we know that the plague would never leave.

Plague and New Mexico

On June 26, 2017, The Santa Fe New Mexican reported that two more cases of human plague were discovered in New Mexico. The 52-year-old woman and 62-year-old woman were the second and third people diagnosed with human plague this year in Santa Fe County, after a 63-year-old Santa Fe man was diagnosed on June 6. Though all three patients have since recovered from the disease, the national media quickly picked up on this story, with such attention-grabbing headlines like that of The New York Times - "Plague Is Found in New Mexico. Again."

But plague is far from new to New Mexico. It's been around for a long time - and it's not going away anytime soon. From its first recorded overture during the height of the Byzantine Empire in 542 A.D. to the plague's intertwining narrative with characters involved in the Manhattan Project, the story of the plague's long journey to New Mexico - and particularly its recurrences in Taos - is that of a relentless cycle that returns, now and again, to instill terror and misery upon civilization. In other words, it's a good thing we have antibiotics nowadays.

Tiny pest, big misery

Plague has existed for more than a thousand years. Its scientific name is Yersinia pestis, a strain of bacteria that infects fleas, which in turn infect and live on rodents. When these infected rodents are in close contact with humans and their pets, the fleas can jump to humans and cause plague outbreaks.

Yersinia pestis typically causes bubonic plague, known for its inflammation of the lymph nodes in the groin, creating swellings known as "buboes." Today, if diagnosed early enough and with antibiotic treatment, it is possible to survive plague, but it is still an extremely dangerous disease, with death rates above 50 percent if untreated.

Santa Fe resident Cindy Roper was diagnosed with bubonic plague in 2007, and her chief symptom was only a headache. "Nothing I took would get rid of my headache," Roper was quoted as saying by The Santa Fe New Mexican in 2007. "That's the thing that alerted me, and I think that's what saved me."

That said, bubonic plague has other forms that are just as nasty - the condition can also develop into septicemic plague, which involves the infection of the bloodstream. In this version, the skin and tissues, particularly the extremities of fingers and toes, can turn black and die.

In 2002, Santa Fe couple Lucinda Marker and John Tull came down with plague in New York City after being infected by fleas on their Santa Fe property. Given that the incident came soon after the 2001 anthrax attacks, panic ensued over suspicions that it was part of a bioterrorism event, a theory that was soon dispelled. Marker survived unscathed, but Tull came down with septicemic plague and lost both of his legs due to the disease.

"Every single hour of every single day, the plague affects our lives, but about the only time I really get angry these days is when, because of my physical condition, there is something I want to do but can't," Tull was quoted as saying by The New York Times in 2013. He passed away in 2014 of an unrelated, but rare illness - spindle cell sarcoma.

Finally, should a mammal be infected in the lungs by the plague bacillus, the disease can be spread through the air from person to person in a condition known as pneumonic plague, which is much deadlier and more transmissible.

According to Paul Ettestad, the public health veterinarian of New Mexico, the 63-year-old man diagnosed on June 6 had developed pneumonic plague, so people who had come in contact with him at the hospital had to be administered antibiotics to prevent the disease's spread. This was essential, since pneumonic plague is nearly always fatal if it is not caught in time.

These alarming cases beg a question: How did a disease with such horrifying effects make its way to present-day New Mexico? And how did Dr. Ashley Pond end up looking at the first recorded human case in Taos?

From Constantinople to Santa Fe

Generally, experts believe that an epidemic in 542 A.D. known as the Plague of Justinian, named for the ruling Byzantine emperor of the time, represented the "first pandemic" of Y. pestis. An account by the Greek historian Procopius viscerally described the presence of inflamed buboes in the plague's victims in Constantinople, supporting this diagnosis.

About 800 years later, the Black Death of the Middle Ages arrived in Europe via rats from central Asia and wiped out perhaps more than half of Europe's population. This outbreak of bubonic plague, which entered much of Europe in 1348, consisted of what is known as the "second pandemic." Thereafter, the plague would recur, in cyclical waves, every few decades for the next 400 years.

The third pandemic began in the late 19th century in China, and it saw a major medical breakthrough. In 1894, the doctors Alexandre Yersin and Kitasato Shibasaburō, two bacteriologists working in Hong Kong, more or less simultaneously discovered the bacteria behind the plague, eventually named Yersinia pestis after Yersin. Its identification was a monumental discovery in bacteriology, finally pinning a modern diagnosis to a historically terrifying disease.

Despite the modern diagnosis, rats from Chinese steamships ended up spreading the plague throughout Africa, Asia and the Americas. And the plague would find a stable home in New Mexico - and its first recorded case in the state would be in Taos County.

Patient zero

By the time Pond examined the ill 9-year-old boy in 1949, his family was something of an institution in Taos. According to the University of New Mexico's Health Science Library & Informatics Center, Pond's father, Ashley Pond Jr., served as one of Teddy Roosevelt's "Rough Riders" during the Spanish-American War. Originally from Michigan, Pond Jr. settled down in New Mexico and founded a school for boys called the Los Alamos Ranch School in 1917, where the young Ashley Pond III was one of the first students. (The school closed in 1942 when the Manhattan Project appropriated the school buildings as housing for atomic scientists.)

In 1933, Ashley Pond III studied for an undergraduate degree at Yale and received a medical degree from that same New Haven, Connecticut, institution. Two years later, he held a residency at the University of California Hospital in San Francisco, where he first witnessed the plague. The patient was a veterinary surgeon who had the occupational risk of routinely being exposed to animals and their parasites. Although the diagnosis was made three days after infection, the patient managed to recover.

The episode fascinated Pond and held his attention for many years. He was alarmed when plague experts in California told him that the infected rats, which had traveled aboard Chinese ships to San Francisco, had gone on to infect native North American populations of rodents. This was a process that the California physicians suggested would likely spread eastward, perhaps even travel to New Mexico, where Pond intended to bring his practice.

"Consequently, when I moved to New Mexico later in 1936, I expected to eventually see a case of plague," Pond wrote in his account. "In fact, before 1949 I had sent specimens on a couple of less suspicious cases to the state laboratory in Albuquerque for testing and always received negative reports. The laboratory accused me of crying wolf."

Despite these repeated false alarms with the New Mexico Health Department, Pond had quickly become one of the premier general physicians in Taos, among the first few doctors in town since the storied Thomas "Doc" Martin, the namesake of Doc Martin's Restaurant, had passed away in 1933.

When Pond examined the 9-year-old boy, he knew that something was different about this case. He drained the boy's inflamed lymph node, or bubo, and took a smear. Examining the material under a microscope, he witnessed an organism that appeared to approximate the structure of Yersinia pestis.

Pond proceeded to culture the rest of the material. He injected the culture into guinea pigs and sent some samples to the state laboratory.

The following morning, several of the injected guinea pigs were found dead in their cages. Additional smears under the microscope revealed the plague bacillus.

It began to dawn on Pond that the plague had finally made its way to New Mexico. For the longest time, he had still thought it to be a long-shot scenario. He began to feel paranoid - had he taken the necessary precautions against fleas when he had examined the patient? In his narrative, Pond claimed that taking some "snakebite medicine," or his imbibing of some whiskey, was able to take the edge off his fears.

The next day, the state laboratory confirmed that they were dealing with plague. Pond contacted physicians in San Francisco for advice regarding treatment. After Pond prescribed an antibiotic cocktail of streptomycin and sulfadiazine, the boy began to recover almost immediately.

In the conclusion to his account, Pond wrote, "This was the first case of plague in New Mexico."

A lurking threat

Plague has affected many Western states, such as California, Arizona, Nevada, Wyoming and Colorado, but none so much as New Mexico in the 20th century.

According to data from the New Mexico Health Department, from 1949 to 1959, there were seven reported cases of human plague. From 1960 to 1969, there were 20. From 1970 to 1979, there were 70 - mostly concentrated in Northern New Mexico. The 1980s saw 104 cases. But by the 1990s, the trend began to reverse - with 42 cases in the '90s, 29 cases in from 2000 to 2009 and 17 cases from 2010 to 2016. To date in 2017, three incidents of human plague have been reported in the state.

Plague season in New Mexico usually consists of the summer months of June, July and August, when more people and animals are outside and come in contact with the plague's reservoir populations of rodents.

"We have a lot of different rodents in the piñón and juniper habitat," Ettestad the veterinarian said, explaining that the regional vegetation supports many different types of rodents - including rabbits, prairie dogs and rock squirrels. These rodents, in turn, are potential hosts for infected fleas.

Climatic conditions may also play a role in the wax and wane of the plague in New Mexico. A 1999 study published in The American Society of Tropical Medicine and Hygiene analyzing New Mexican plague cases from 1949 to 1996 revealed a link to annual rainfall. Human plague cases tended to occur 60 percent more frequently in New Mexico in the summers following winters with above-average precipitation (that's compared to summers following drier winters).

"The theory is, with increased rainfall, you have more vegetation and more food for rodent populations," Ettestad said, explaining that higher rodent populations can make for larger potential host populations.

Moreover, fleas thrive under wetter conditions, so more precipitation can only amplify the spread of the disease.

And while this year's cases have centered around Santa Fe County, the plague has remained close to Taos as recently as 2012.

That year, The Taos News reported that two cats owned by Taos resident Rebecca Knight were infected with plague.

"I just noticed that one of them got it first," Knight said. "He was lethargic and getting worse."

It was the veterinarian who noticed the swollen lymph node, and it wasn't long before the second cat became ill.

With antibiotic treatment, the cats recovered, but the New Mexico Health Department blamed an infected prairie dog colony in Taos' very own Sunset Park. At the time, the owners of that park reportedly hired an exterminator to de-flea the prairie dogs without killing them.

One of Knight's cats, named Max, is still alive today. Knight said that she suspects that at least one of her cats killed an infected rodent and a flea subsequently bit her pet.

"In the future, when I have other cats in my life, I would not have them outdoors, free-range, all the time," Knight said. "But it is too late for the cat I have now," explaining that her cat wasn't going to stop being an "outdoor cat" overnight.

According to The Santa Fe New Mexican, there have been 17 cases of plague in animals in New Mexico in 2017 so far. The New Mexico Department of Health recommends precautionary measures that involve eliminating rodent nesting places, such as rock piles, trash or firewood in backyards.

Most plague cases tend to be in places that have also seen a lot of urban growth in recent years, such as Santa Fe and Torrance County.

"There are a lot of people moving to those areas building homes on where prairie dogs live," Ettestad said, adding that these homeowners might allow their pets to hunt and that these pets might hunt sick rodents. Next, fleas can jump onto the pets, Ettestad explained, and then the fleas can bite humans.

And so the cycle continues.

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