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Fresno Doctor on Bubonic Plague: It's Rare But It's Out There. Prevention Is Key
Edward Smith updated website photo 2024
By Edward Smith
Published 12 hours ago on
August 21, 2025

Rodents such as squirrels can carry the fleas that transmit bubonic plague. Insect repellant and long clothes can keep the disease from spreading. (GV Wire Composite)

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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 — shouldn’t 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,. The the key thing is to identify early and start them on treatment early.” — Dr. Geetha Sivasubramanian, associate professor of medicine and chief of infectious disease, UCSF Fresno

“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 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.

Plague symptoms aren’t unique, and because the disease is so rare it can be overlooked for testing, she said. If you 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.”

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Edward Smith,
Multimedia Journalist
Edward Smith began reporting for GV Wire in May 2023. His reporting career began at Fresno City College, graduating with an associate degree in journalism. After leaving school he spent the next six years with The Business Journal, doing research for the publication as well as covering the restaurant industry. Soon after, he took on real estate and agriculture beats, winning multiple awards at the local, state and national level. You can contact Edward at 559-440-8372 or at Edward.Smith@gvwire.com.

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