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A rare airborne form of the plague that potentially can be spread through coughing and sneezing has infected a Colorado man, said state health officials who are searching for other possible cases there.

The man, who hasn’t been identified, is infected with pneumonic plague, an inhaled form, which is more often spread through flea bites and remains endemic in some parts of the world.

It’s the first case of pneumonic plague seen in the state since 2004, said Jennifer House, a spokeswoman for the Colorado Department of Public Health and Environment. The man may have been exposed in Adams County near Denver, health officials said July 9 in a statement.

House said the man has been hospitalized and treated, and is no longer infectious, but she wouldn’t release other details.

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“He’s on treatment long enough to not be transmissible,” House said in a telephone interview. He may have contracted the illness from his dog, she said, which died suddenly and has also been found to carry the disease.

“We don’t think it’s out in our air,” House said. “We think it’s in our dead animal populations and dead rodent populations.”

Plague in all of its forms infects only about seven people a year in the U.S. The disease occurs when a bacterium named Yersinia pestis infects the body, according to the U.S. Centers for Disease Control and Prevention.

The difference between the pneumonic and bubonic varieties is that the bacteria take hold in the lungs in the first case, rather than underneath the skin through insect bites. Both types are treated with antibiotics.

Plague first came to the U.S. in about 1900 on ships infested with rats, which can carry plague-carrying fleas, according to the CDC website. The last urban outbreak of plague in the U.S. occurred in Los Angeles in 1924 and 1925, CDC said.

Rare plague infections occur in a few Western rural areas, including northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon and far western Nevada, according to the Atlanta-based agency.

The disease continues to spread in some areas in eastern and central Africa, and a few parts of Asia and South America, according to the World Health Organization.

Colorado has had 60 cases of all types of plague since 1957, and nine people have died, the state said.

Untreated plague is fatal, and antibiotics have to be given within 24 hours of the first symptoms to reduce the chance of death. Symptoms include fever, headache and chest pain, along with a pneumonia that develops rapidly causing shortness of breath, chest pain and bloody mucus, according to the CDC.

There is no vaccine available for plague in the U.S.

The bubonic form is the most common, best known for its outbreaks in the Middle Ages. Bubonic plague occurs when a person is infected through the skin, usually through the bites of fleas.

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