The bubonic plague – the most destructive pandemic ever that killed millions in the Middle Ages – is still with us. While it is unlikely that it will return with the vengeance of the Spanish influenza or Covid, it does pop up from time to time.

This once massive killer offers insights into how to deal with huge, unexpected, future health crises.

According to the Centers for Disease Control and Prevention, about seven cases of plague appear each year in the U.S. A few weeks ago, one person in Oregon was infected by a pet cat, which had probably been bitten by a flea.

It has not turned into a mass pandemic; the person who contracted the illness survived. A few years ago, a couple of people in New Mexico picked up the illness from contact with prairie dogs in the desert.