An average of 7 cases per year is reported in the US. See:
https://www.cdc.gov/plague/maps/index.html
Why are there no records from the east of the country?
I would assume that the vectors for the disease (rats and fleas) carrying the disease are mostly common around those areas where the disease has been reported. Sure, rats and fleas are probably present in many other locations too, but either not in direct contact with humans or not carrying the disease. There is also a slim chance of spreading the disease between sick individuals, maybe this could have also strengthen the pattern seen.
@ Carl
In addition, various rodents beyond rats, marmots included, particularly in Central Asia, may act as vectors and reservoirs.
Currently, the plague is not as virulent as it used to be in medieval and early modern Europe.
Under-reported definitely, world-wide.
In the US, the few cases of plague mostly occur in the South West. Hot spots are Madagascar and Mongolia. Am sure many cases are not reported.
But you certainly know that plague can successfully be treated (streptomycin, tetracylin and further antibiotics). Some resistance to streptomycin iis now observed in Madagascar.
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