Why Are We Still Hearing About Bubonic Plague in 2024?

Fact checked by Nick Blackmer

Key Takeaways

• Although the plague never fully went away, there are only seven new cases each year in the United States.

• The plague is spread through flea bites or direct contact with the tissues or fluids of an infected animal.

• Common antibiotics can treat the plague
  

An Oregon resident likely contracted bubonic plague from their cat, according to local health officials.

The bubonic plague is an infectious disease caused by the Yersinia pestis bacteria. The disease—once known as the “black death”—killed at least 50 million people in medieval Europe, but now, only about seven people get infected in the United States each year.

Cases of plague mostly occur in rural areas of the western U.S., where rodents are prone to fleas that may carry plague bacteria. Humans can get infected with bubonic plague either through flea bites or direct contact with the tissues or fluids of an infected animal.

The plague is treatable with common antibiotics, so health authorities are not worried about an outbreak following the Oregon case.

“This person had what we call an infected lymph node, which does not pose a threat to the family members or anyone else that could have been in contact with it,” said Emilio DeBess, DVM, MPVM, the state public health veterinarian at Oregon Health Authority.

What Are the Symptoms of Plague?

Bubonic is the most common type of plague. It causes fever, chills, headaches, and painful swollen lymph nodes—called buboes—near the site of the flea bite.

“If you got a flea bite on your hand, then you would have a swollen node in your axilla [armpit]. If you got a flea bite on your leg, then you’d have a swollen node in your groin,” Timothy F. Brewer, MD, MPH, professor of medicine and epidemiology at the University of California, Los Angeles, told Verywell.

Untreated bubonic plague can progress to septicemic or pneumonic plague. Septicemic plague—which can also result from flea bites or handling an infected animal—is characterized by symptoms such as fever, chills, weakness, shock, abdominal pain, and black, dead skin on the fingers, toes, and nose.

Pneumonic plague—the most severe form of plague—may develop from inhaling infectious droplets as well. It’s a lung infection that causes fever, headache, chest pain, coughing, and shock.

“Pneumonic plague is so severe and so quick that you don’t get buboes, and usually those patients need to be treated right away or they will succumb to the disease,” Brewer said.

How Is Plague Treated?

It’s fairly easy for healthcare providers to diagnose bubonic plague if the patient has flu-like symptoms and painful swollen buboes. Septicemic and pneumonic plague often have no obvious signs, but a diagnosis can be made through blood cultures and lab testing.

Untreated pneumonic plague can be fatal in less than 24 hours. Treatment is started as soon as plague is suspected, even if the results of a blood culture are not available yet.

“The good news is that widely available antibiotics do work against plague,” Brewer said.

Antibiotic treatments can last 10–14 days or for two days after a person’s fever breaks. A patient may start with intravenous (IV) antibiotics first but switch to oral medications once they start feeling better. The key is to get the patient on these treatments as soon as possible, Brewer added.

People who are treated early are likely to recover from the plague fully. Sometimes, close contacts of patients with pneumonic plague may be given preventative antibiotics.

“This is really a rare problem and not something that most people need to worry about,” Brewer said.

What This Means For You

Your risk of contracting the plague is extremely low. If you live in a semi-rural or rural area in the western U.S., you can reduce your risk of plague by making your home rodent-proof. If you have pets that roam free in outdoor areas, apply preventive flea medications and don't allow them to sleep on your bed.

Read the original article on Verywell Health.