A reported plague infection in South Lake Tahoe raised alarms as the disease known for the devastation it caused in Medieval Europe returned to the news.

Today, bubonic plague, known as Yersinia pestis, can be found in fleas clinging to wildlife throughout California’s mountains. The difference, however, is how treatable the disease is with the advent of antibiotics, said Dr. Geetha Sivasubramanian, associate professor of medicine and chief of infectious disease at UCSF Fresno.

“Especially in western states like California (and) Arizona, we do periodically see cases. I would say in the U.S. in total we probably see maybe like eight cases a year, so it is still extremely rare,” Sivasubramanian said. “I wouldn’t panic just seeing that one case.”

However, people — hikers and campers especially — should take precautions.

Insect Repellent, Long Sleeves and Pants, and Don’t Forget to Protect Your Pets

While the disease can be easily treated with common antibiotics, the best tool is prevention, Sivasubramanian said.

Insect repellent and long clothes largely do the trick to keep the insect off of you. Be sure the insect repellent has at least 30% DEET. Outdoor pets are also highly susceptible to plague via fleas, so keep pets indoors or use flea protection.

The National Park Service also warns against touching or feeding wild animals. Feeding wild animals can encourage squirrels and other rodents to come close to humans. Fleas will hang around dead animals, so handling dead animals can also spread infection.

Early Treatment Key

If bubonic plague is contracted, it needs to be treated early. In July, a person in Arizona died from the disease — the first death in the region in 18 years, the Independent reported.

“It’s not a special antibiotic, it’s not hard treatment. There are easily available antibiotics, pill antibiotics that then can be given,” Sivasubramanian said. “The key thing is to identify early and start them on treatment early.”

Symptoms are very similar to the flu; fever, body aches, nausea, Sivasubramanian said. What distinguishes it is lymph node swelling called buboes. Normally, buboes will appear near where the bite occurred, she said. Bites on the legs will likely cause swelling near the groin while bites on the arm will cause swelling near the armpit.

In some very rare cases, pneumonic plague can spread via respiratory droplets after close contact with an infected person or animal, the Fresno County Department of Public Health told GV Wire. People are at the highest risk after rodents such as squirrels, woodrats, or chipmunks die and fleas seek new hosts.

Plague symptoms aren’t unique, and because the disease is so rare it can be overlooked for testing, Sivasubramanian said. If you develop symptoms and have been camping or been around rodents, tell your health care provider. Incubation period between a bite and symptoms is often seven to 10 days, she said.

“It’s still a very rare disease and nowadays a very treatable, curable disease,” Sivasubramanian said. “So good to be aware, but no need to panic.”

Plague Endemic to Fresno County Foothills

In California, 64 cases of plague have been reported, the public health department told GV Wire. The disease is considered endemic in wild rodent populations in the foothills and mountain zones, though there haven’t been any recent cases in Fresno County.

In 2015, two people contracted the disease after visiting Yosemite National Park, according to the National Library of Medicine. One of those cases was considered septicemic, which Sivasubramanian said means the disease goes from the lymph nodes into the blood stream, causing sepsis.