(fever and buboes--i.e., swollen, painful lymph nodes). But it is seen each year in the West/Southwest. Fleas spread the bacteria, most often to prairie dogs, which can then pose a threat to other animals, especially cats and dogs--thus posing a threat to pet owners and veterinarians.
Plague is "back?" No. It never went away and is unlikely to ever do so. It could pose a big issue outside the West because of a failure to recognize it. However, in the West/Southwest, most physicians are more readily aware of it as a possibility, given consistent symptoms among those spending a lot of time in areas where infected animals/fleas can pose a threat. Tularemia (another flea-borne/animal excretia-spread bacterial infection is the most common infection that must be differentiated. If you have wild rabbits nearby in these areas and notice die-offs, tularemia is most likely the cause, and people can be exposed while doing gardening and yardwork.
When infected people present to physicians/ERs outside the West, there can be real difficulty in getting a timely and accurate diagnosis--especially when occupation, travel, and potential exposure histories are not obtained (an increasing problem in busy ERs).
However, CDC's epidemiologists, entomologists, and labs (both in Atlanta and Fort Collins, CO, have long been active in human, animal and vector surveillance, disease investigation, and laboratory confirmation has been impacted by these very unwise staff and funding cuts. We may all pay a price for this and other disease spread as a result. Physicians in these areas and other knowledgeable health care staff know the risks being posed by DOGE and RFK Jr's cluelessness. But, alas...
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