What it was like to catch a rare strain of this old-school disease.

By Katie Simon
Updated March 07, 2021
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When I took a gap year before college at age 18, I planned a trip to explore the Silk Road, a dream I'd had since childhood. While I was traveling through Central Asia from Uzbekistan to Western China, I expected to sample unusual foods, befriend backpackers from around the world, and spend a lot of time getting lost. What I didn't expect? To collapse in the middle of the desert and take a ride to a Kazakh hospital in a Soviet-era ambulance staffed by chain-smoking nurses. I also didn’t expect to spend the next year battling an extremely rare disease that most people associate with 14th century Europe.

I kicked off my trip in Kazakhstan. Just a few days in, I started feeling sick. I blamed my limited diet—a lot of eggs and oily rice—and brushed it off. Then, during a 24-hour bus trip out of the country, I threw up at every rest stop and couldn’t keep any liquids down. I just tried to rally. After all, I was in the middle of the desert, hours away from the nearest large city. What choice did I have?

In the end, my body made the choice for me. I blacked out and was taken to the nearest hospital in that smoky, rickety ambulance.

I was in the hospital for three days and underwent dozens of tests: X-rays, EKGs, MRIs, blood tests, stool tests, urine tests, and more. My Kazakh doctors officially diagnosed me with pancreatitis, an inflammation of the pancreas that can have the same gastrointestinal symptoms that I was experiencing.

I figured I must have picked up some extra-nasty food poisoning, made worse by dehydration during my long bus ride. I decided to continue my backpacking trip and headed to Israel.

I didn't get better. I threw up all the time, often after eating or drinking, and my heartburn wouldn't go away. I visited more doctors while in Israel, but they were all stumped. They gave me probiotic supplements and sent me on my way.

After months of those symptoms, I also started to get throat and sinus infections, along with constant colds. It was pretty clear my immune system was struggling—badly.

Despite my strange symptoms, I survived the seven-month trip, and headed back home. In the United States, I visited specialist after specialist. I saw my old pediatrician, travel doctors, my parents’ internist, a naturopath, and a gastroenterologist. All my test results came back negative. Everybody wrote me off as another backpacker who came back with some bug she picked up while traveling. They told me if I just waited it out, my symptoms would go away.

At that point in my life, I'd traveled to more than 60 countries, and spent years of my life outside of the U.S. I'd experienced food poisoning, infections, and traveler’s diarrhea. I knew what “typical travel sickness” looked like—being sick for months on end was not typical.

Almost an entire year after my first symptoms, while moving into my freshman dorm at NYU, I got a call from the gastroenterologist’s office I'd visited a few weeks before.

“Don’t look this up on Wikipedia,” the nurse told me over the phone. “You tested positive for Yersinia.”

I was on Wikipedia before she hung up.

Yersinia pestis is the bacterium that causes the bubonic plague, which wiped out a third of Europe’s population in the 14th century (also known as "The Black Death"). Today, Yersinia pestis infections are super rare. Only a couple thousand people are diagnosed with it each year, including just a handful of Americans. Most cases occur in Central Asia, which is where I picked it up.

My doctor guessed that I had caught a strain similar to bubonic plague—either from contaminated food or flea bites—that only affected my upper gastrointestinal system (esophagus, stomach, and duodenum). Other types of Yersinia can kill you within days. I was really lucky.

My hometown issued a public health warning after my diagnosis, though my strain was highly unlikely to infect anybody else. According to my doctor, they would probably have to ingest fluids from my stomach to catch it (gross!).

My doctor gave me a simple course of antibiotics, which successfully killed off the Yersinia bacteria in my system. But many of my symptoms were still there. Twelve months of acid reflux and vomiting had completely messed with my stomach and esophagus. To help my body repair itself, I stuck to a strict diet: no acidic, spicy, or fatty foods; no caffeine or alcohol. My naturopath recommended I cut other irritants like gluten, processed sweeteners, and dairy. I'd been vegetarian for six years, so meat was also off the table. But after losing nearly 20 pounds in the first month, I realized I needed to relax my vegetarian standards, so I started eating seafood to keep my weight steady.

The food restrictions were challenging, especially as a college freshman. While my friends drank beer, I drank coconut water. When we went out to meals, I ordered a bland side dish while my friends indulged in New York City’s food scene. I even missed out on baguettes, brie, and croissants when I studied abroad in Paris.

Though my symptoms improved, I found that when I tried to taper off my strict diet and introduce new foods, some dormant symptoms came back worse than before. I went back to my gastroenterologist, but she wasn’t very concerned. When I insisted that something was off, she scheduled an endoscopy.

It turns out I was right. My entire upper digestive system was inflamed, and I had erosions and pre-ulcers throughout my esophagus, stomach, and duodenum. My doctor prescribed powerful acid reflux medication and told me to stick to the strict diet for a bit longer while the medication (hopefully) helped me heal. Several months later, I was luckily able to eat new foods without any scary side effects.

It took two and a half years to completely recover from one freak bacterial infection. But, believe it or not, it wasn’t all horrible. In those two and a half years, I learned how to stand up for myself when doctors and authority figures didn’t take me seriously. I learned to trust my intuition and listen to my body. And when I finally recovered, I had one more crazy travel story to share.