Ask the Pharmacist: Bubonic plague is on the rise

Suzy Cohen
This file photo shows a yellow-bellied marmot in the United States. A couple in Mongolia died from the bubonic plague after eating raw marmot meat.

Let’s talk about bubonic plague from a medical standpoint, not a political one. It’s making a new deadly appearance, after being extinct for a long time in the United States. Controlling its spread is imperative to our safety and survival. It’s making a resurgence, especially in California and what’s scary is that it spreads quickly. 

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Just FYI, the plague was the second biggest killer on our planet, second only to smallpox. Symptoms vary from person to person however, the first sign is a fever with nausea and vomiting. Then there will be swollen, painful lymph nodes that occur in the armpits, groin or neck. Skin sores are hallmark, and they turn black that’s why Bubonic Plague is also known as “Black Death.” Shortness of breath, coughing and wheezing are possible too.

People died from this so quickly that large groups of folks were commonly buried in mass graves. Bubonic plague is on the rise here because of the perfect storm of problems. It’s caused by a bacterium called Yersinia pestis. There is debate about whether it is spread through the air, or by fleas, or both, but either way it is a deadly disease.

Right now, the most predominant location for Bubonic Plague is in California, but it’s also popping up in Arizona and New Mexico. In Colorado where I live, there was a wildlife shutdown in Denver last week.

But California, especially San Francisco and Los Angeles, is where the humanitarian crisis is occurring, and we must do something fast. There is a lot more homelessness in these cities. This naturally leads to fecal matter being scattered on the streets. In combination with rotting food, needles and other trash, rats have made it their home because they thrive in the infestation. 

The rats carry the fleas with the plague, which then potentially infect people and pets. Squirrels, rabbits, mice, coyotes and other animals can be carriers, it’s not just rats.

So, minimizing the trash and the rats would help in reducing the rate of infection. But strangely, California is proposing to ban anticoagulant rat poison, which translates to more rats and more cases of the plague. Sacramento was recently forced to close an outdoor playground because of the rats as they were naturally worried about children getting ill. 

Once inside the body, the germ ‘explodes’ and essentially injects poison into special immune cells that are defensive in nature (macrophages), Once knocked out, your macrophages can no longer detect the germ. The bacteria then grow wildly and quickly, and kills the host, unless detected and treated very quickly.

Reduce risk by treating your pets for fleas, and not letting them mix with rodents or wildlife. Control rodents with rodenticides or traps. Wear insect repellent that works and keep your pets away from feces and remains of dead animals. Keep pets out of the bed. Avoid travel to areas that are infested. 

As for natural remedies, there is so much silliness on the Internet. Trust me, rubbing your body with a chicken will not cure you of the plague! Neither will leeches. Doxycycline, and gentamicin may be useful. Streptomycin is an older drug which is one of our gold standards. 

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit