Two new cases of the human plague have been confirmed in Sante Fe County, New Mexico, according to health officials.
The New Mexico Department of Health (NMDOH) says the disease has been reported in two women, 52, and 62.
The first case of the year was reported earlier this month in a 63-year-old man. All three patients were hospitalized but there have been no deaths.
NMDOH conducted environmental investigations around their homes to try and find risks to family members and neighbors.
The disease, which once killed millions of people in Europe during the Middle Ages, can now be treated with antibiotics, according to the Centers for Disease Control and Prevention. Though without proper treatment, the disease can still cause serious illness and death.
The state dealt with the plague recently with four reported cases in both 2016 and 2015. One person died in the state two years ago from the disease.
The plague is a bacterial disease of rodents and is generally transmitted to humans from flea bites, but can also be spread from direct contact with animals including wildlife and pets. Symptoms of the plague include sudden onset of fever, chills, headache and weakness, according to NMDOH. There can also be painful swelling of the lymph node in the groin, armpit or neck.
NMDOH recommends protecting pets by using safe flea control, taking them to a veterinarian promptly, and keeping their food and water away from areas with mice.
The organization says around the house clean up areas where rodents live like wood and brush piles, junk and abandoned vehicles. They also suggest putting wood, hay and compost as far away from your home as possible.
The Associated Press contributed to this report.