A northern Arizona resident has died from the pneumonic plague, health officials confirmed on Friday, the first such death in Coconino County in nearly 20 years.

A person in northern Arizona has died from a case of pneumonic plague, local health officials said. The unidentified patient, from Coconino County, showed up to the Flagstaff Medical Center Emergency Department and died there the same day, Northern Arizona Healthcare said in a statement. It is unclear when the death occurred.

The patient had arrived at Flagstaff Medical Center and died in the emergency room. It is the first known plague-related death in Coconino County since 2007.