Bubonic plague is one form of plague passed to people exposed to Yersinia pestis. This is an extremely dangerous illness, and it can result in other forms of illness that create severe blood or respiratory infection. There is one treatment for plague of this type: antibiotics during hospitalization. Risk of death is very high without treatment, as is evidenced in human history by accounts of plague causing millions of deaths, particularly in the Middle Ages. Prior to the development of antibiotics, there was no successful bubonic plague treatment.
Someone might be suspected of having bubonic plague if they’ve recently been exposed to sources of Yersinia pestis. Typically, exposure occurs when a person has been in close contact with a sick animal, often a rodent, or more frequently, received a fleabite from a flea that had contact with a sick animal. In the US, areas where there may be pockets of plague include parts of California, Nevada, Utah, New Mexico and Arizona. Elsewhere in the US, it’s unlikely people will need bubonic plague treatment because the chance of exposure is minimal. Even in those areas where plague might be present, chance of contracting it is low.
On the other hand, it’s not impossible to need bubonic plague treatment, and symptoms like chills, fever, muscle pain, swelling around the glands called buboes, headache and possibly seizure could indicate exposure. If plague is suspected, people must be hospitalized. Provided the condition is thought to be true bubonic plague, and not another form of Yersinia pestis infection called pneumonic plague, the person isn’t contagious and doesn’t require isolation.
Doctors begin bubonic plague treatment with antibiotics, often even before they confirm a diagnosis of plague with blood cultures or cultures of an enlarged lymph node or saliva. Haste is desired because people have a better outcome if they’re treated within the first 24 hours after symptoms begin to show. Typical antibiotics used can vary. Gentamicin, ciprofloxacin, doxycycline and streptomycin are all options.
Antibiotics are usually administered through an intravenous (IV) line, and this can be useful because fluids can be co-administered. This might help with fluid loss caused by high fever. Fever-reducing medicines could also be used if they appear appropriate.
Due to risk that bubonic plague may impair breathing or cause seizures, hospital bubonic plague treatment might include respiratory support. If necessary, patients could have oxygen or they might need a breathing tube if breathing is seriously affected. With hospital support and antibiotics, many people recover fully from this illness.
Physicians stress that early treatment is vital, and any symptoms that bubonic plague is instead pneumonic or septicemic plague need to be treated earlier and with care. These types of Yersinia pestis infections aren’t as effectively treated, though many can respond to treatment with early care. People with pneumonic plague are isolated because they are contagious. Anyone exposed to pneumonic plague is usually given a course of preventative antibiotics and watched carefully for any signs of developing the illness.