www.healthline.com Open in urlscan Pro
3.162.125.33  Public Scan

Form analysis
2 forms found in the DOM

/search

<form id="healthline-search-form" action="/search" class="css-70qvj9"><button type="submit" aria-label="Open Healthline Search" aria-expanded="false" data-testid="nav-search-button" class="css-6fmqbr"><svg viewBox="0 0 41 41" width="40" height="40"
      class="css-hk28k6">
      <use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-search"></use>
    </svg></button></form>

POST /newsletter-signup

<form action="/newsletter-signup" method="post" novalidate="" class="css-30l4a7">
  <div class="css-8i1gnu"><input placeholder="Enter your email" aria-label="Enter your email" type="email" class="css-egeqy3 hl-id-class"></div><button class="hl-id-class css-1nifosy" data-testid="button" type="submit"><span class="css-14ktbsh"><span
        class="css-1huyk6v">SIGN UP</span></span></button>
</form>

Text Content

Healthline
 * Health Conditions
 * Discover
 * Plan
 * Connect


Subscribe










THE PLAGUE


Medically reviewed by Alana Biggers, M.D., MPH — Written by The Healthline
Editorial Team — Updated on February 28, 2022
 * Symptoms
 * Types
 * Causes
 * If you think you have plague
 * Diagnosis
 * Treatment
 * Prevention
 * Prevalence
 * Outlook

The plague is a serious bacterial infection that can be deadly. Sometimes
referred to as the “black plague,” the disease is caused by a bacterial strain
called Yersinia pestis. This bacterium is found in animals throughout the world
and is usually transmitted to humans through fleas.



The risk of plague is highest in areas that have poor sanitation, overcrowding,
and a large population of rodents. Over the last 20 years, nearly all cases have
been reported among people living in small and agricultural villages rather than
overcrowded cities.

In medieval times, the plague was responsible for the deaths of millions of
people in Europe.

Today, there are only 1,000 to 2,000 casesTrusted Source reported worldwide each
year, with the highest incidence in Africa, particularly Madagascar.

The plague is a rapidly progressing disease that can lead to death if untreated.
If you suspect you have it, call a doctor right away or go to an emergency room
for immediate medical attention.


SIGNS AND SYMPTOMS OF THE PLAGUE

People who have the plague usually develop flu-like symptoms two to 6 days after
infection. There are other symptoms that can help distinguish the three forms of
the plague.

Share on Pinterest


BUBONIC PLAGUE SYMPTOMS

Symptoms of bubonic plague generally appear within two to 8 days of infection.
They include:

 * fever and chills
 * headache
 * muscle pain
 * general weakness

You may also experience painful, swollen lymph glands, called buboes. These
typically appear in the groin, armpits, neck, or site of the insect bite or
scratch. The buboes are what give the bubonic plague its name.


SEPTICEMIC PLAGUE SYMPTOMS

Septicemic plague symptoms usually start within a few days after exposure, but
septicemic plague can lead to death before symptoms even appear. Symptoms can
include:

 * abdominal pain
 * diarrhea
 * nausea and vomiting
 * fever and chills
 * extreme weakness
 * bleeding (blood may not be able to clot)
 * shock
 * skin turning black (gangrene)


PNEUMONIC PLAGUE SYMPTOMS

Pneumonic plague symptoms may appear as quickly as one day after exposure to the
bacteria. These symptoms include:

 * trouble breathing
 * chest pain
 * cough
 * fever
 * headache
 * overall weakness
 * bloody sputum (saliva and mucus or pus from the lungs)

TYPES OF PLAGUE

There are three basic forms of plague:


BUBONIC PLAGUE

The most common form of the plague is bubonic plague. It’s usually spread by the
bite of an infected flea. In very rare cases, you can get the bacteria from
material that has come into contact with a person who has the infection.

Bubonic plague infects your lymphatic system (a part of the immune system),
causing inflammation in your lymph nodes. Untreated, it can move into the blood
(causing septicemic plague) or to the lungs (causing pneumonic plague).


SEPTICEMIC PLAGUE

When the bacteria enter the bloodstream directly and multiply there, it’s known
as septicemic plague. When they’re left untreated, both bubonic and pneumonic
plague can lead to septicemic plague.


PNEUMONIC PLAGUE

When the bacteria spread to or first infect the lungs, it’s known as pneumonic
plague — the most lethal form of the disease if untreated.

When someone with pneumonic plague coughs, the bacteria from their lungs are
expelled into the air. Other people who breathe that air can also develop this
highly contagious form of plague, which can lead to an epidemic.

While pneumonic plague can be fatal if left untreated, recovery rates are
typically very high if treated within the first 24 hours when symptoms present
themselves.

Pneumonic plague is the only form of the plague that can be transmitted from
person to person.


CAUSES OF PLAGUE

People usually get the plague through the bite of fleas that have previously fed
on infected animals like mice, rats, rabbits, squirrels, chipmunks, and prairie
dogs. It can also be spread through direct contact with a person or animal that
has the infection or by eating an infected animal.

Plague can also spread through scratches or bites of infected domestic dogs or
catsTrusted Source.

Pneumonic plague can be spread from person to person through cough droplets that
contain plague bacteria. It’s rare for bubonic plague or septicemic plague to
spread from one human to another.

RISK FACTORS OF PLAGUE

In most cases, being at risk of contracting the plague is relatively rare.
However, there are a few factors that may increase your risk. These can include:

 * direct contact with someone who contracted the plague
 * homes with high exposure to rodents or fleas that may be infected with plague
 * living in a rural or semi-rural location that is extremely agricultural


WHAT TO DO IF YOU THINK YOU MIGHT HAVE THE PLAGUE

Plague can be a life threatening disease if left untreated. If you have been
exposed to rodents or fleas, have visited a region where plague is known to
occur, and you develop symptoms of plague, contact your doctor immediately and
have the following information available:

 * Be prepared to tell your doctor about any recent travel locations and dates.
 * Make a list of all over-the-counter medications, supplements, and
   prescription drugs you take.
 * Make a list of people who have had close contact with you.
 * Tell your doctor about all your symptoms and when they first appeared.

When you visit the doctor, emergency room, or anywhere else where others are
present, wear a surgical mask to prevent the spread of the disease.

HOW THE PLAGUE IS DIAGNOSED

If your doctor suspects you may have the plague, they’ll check for the presence
of the bacteria in your body:

 * A blood test can indicate whether you have septicemic plague.
 * To check for bubonic plague, your doctor will use a needle to take a sample
   of the fluid in your swollen lymph nodes.
 * To check for pneumonic plague, doctors will either take a blood sample or
   sample from the swollen lymph node and send it for laboratory testing.

The samples will be sent to a laboratory for analysis. Preliminary results may
be ready in just 2 hours, but confirmatory testing takes 24 to 48 hours.

If the plague is suspected, your doctor will still begin treatment with
antibiotics even before the diagnosis is confirmed. This is because the plague
progresses rapidly, and being treated early can make a big difference in your
recovery.



TREATMENT FOR THE PLAGUE

The plague is a life threatening condition that requires urgent care. If caught
and treated early, it’s a treatable disease using antibiotics that are commonly
available.

With no treatment, bubonic plague can multiply in the bloodstream (causing
septicemic plague) or in the lungs (causing pneumonic plague). Death can occur
within 24 hours after the appearance of the first symptom.

Treatment usually involves:

 * Strong and effective antibiotics such as gentamicin or ciprofloxacin,
   intravenous fluids, oxygen, and, sometimes, breathing support.
 * Those with pneumonic plague must be isolated from other patients in order to
   avoid transmission.
 * Treatment will continue for several weeks even after your fever breaks.
 * Those in contact with someone with plague will be closely monitored, and
   possibly given antibiotics as a preventative measure.

COMPLICATIONS

If diagnosed early, treatment for plague can be extremely successful with proper
antibiotics. However, the main complication that may interfere with successful
treatment is the timing of diagnosis and when treatment begins.

Plague can be fatal if not treated quickly, so it’s important to visit the
doctor as soon as symptoms appear.


HOW TO PREVENT PLAGUE

There are a few ways to prevent exposure to plague bacteria:

 * Keep the rodent population in your home and workplace under control.
 * Avoid keeping piles of debris such as firewood, rocks, and vegetation brush
   in areas you frequent.
 * Protect any outdoor pets from getting fleas by using flea control products.
 * If you are in high-risk areas of plague, dob’t allow pets to roam freely
   outside or sleep in your bed.
 * If your pet starts getting sick, visit the veterinarian right away.
 * Always wear insect repellent (chemical or natural) while outdoors.
 * Visit your doctor immediately if you believe you’ve been exposed to infected
   rodents or fleas.
 * Be able to recognize symptoms of each type of plague in order to get treated
   as soon as possible.
 * Avoid direct contact with those you suspect have been exposed to plague
   bacteria.

There’s currently no commercially available vaccine against plague in the United
States. So it’s important to take preventive measures in avoiding any contact
with plague or any creature that carries it.

WHERE IS PLAGUE FOUND?

Epidemics of plague killed millions of people (about one-quarter of the
population) in Europe during the Middle Ages. It came to be known as the “black
death.” That’s not quite the case anymore.

Today the risk of developing plague is quite low, with only 3,248 cases and 584
deathsTrusted Source reported to the World Health Organization (WHO) from 2010
to 2015.

Outbreaks are generally associated with infected rats and fleas in the home.
Crowded living conditions and poor sanitation also increase the risk of plague.

Today, most human cases of the plague occur in Africa, though they do appear
elsewhere. The countries in which the plague is most common are Madagascar, the
Democratic Republic of Congo, and Peru.

The plague is rare in the United States, but the disease is still sometimes
foundTrusted Source in the rural Southwest, in particular Arizona, Colorado, and
New Mexico. The last epidemic of plague in the United States occurred in 1924 to
1925 in Los Angeles.

In the United States, reported casesTrusted Source average seven per year. Most
have been in the form of the bubonic plague. There hasn’t been a case of
person-to-person transmission of the plague in U.S. urban areas since 1924.

In 2019, the Center for Disease Control and Prevention (CDC) reported only one
case of the plagueTrusted Source in the United States.

OUTLOOK FOR PLAGUE PATIENTS

Plague can lead to gangrene if blood vessels in your fingers and toes disrupt
blood flow and cause death to tissue. In rare cases, plague can cause
meningitis, an inflammation of membranes that surround your spinal cord and
brain.

Getting treatment as quickly as possible is crucial to stop the plague from
becoming deadly.



Last medically reviewed on February 28, 2022


HOW WE REVIEWED THIS ARTICLE:

Sources
History
Healthline has strict sourcing guidelines and relies on peer-reviewed studies,
academic research institutions, and medical associations. We avoid using
tertiary references. You can learn more about how we ensure our content is
accurate and current by reading our editorial policy.
 * Melman SD, et. al. Human case of bubonic plague resulting from the bite of a
   wild Gunnison's prairie dog during translocation from a plague-endemic area.
   (2017).
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859330/
 * Maps and statistics: Plague in the United States. (2021).
   https://www.cdc.gov/plague/maps/index.html
 * Prevent tick and mosquito bites. (2019).
   https://www.cdc.gov/ncezid/dvbd/about/prevent-bites.html
 * Plague: Ecology & transmission (2019).
   http://www.cdc.gov/plague/transmission/index.html
 * Plague. (2016).
   https://www.niaid.nih.gov/diseases-conditions/plague
 * Plague. (2017).
   http://www.who.int/entity/mediacentre/factsheets/fs267/en/index.html

Our experts continually monitor the health and wellness space, and we update our
articles when new information becomes available.

Current Version

Feb 28, 2022

Written By

The Healthline Editorial Team

Edited By

Amy Boshnack

Medically Reviewed By

Alana Biggers, MD, MPH

Copy Edited By

Stassi Myer - CE

Sep 17, 2018

Written By

The Healthline Editorial Team

VIEW ALL HISTORY

Share this article



Medically reviewed by Alana Biggers, M.D., MPH — Written by The Healthline
Editorial Team — Updated on February 28, 2022





WAS THIS ARTICLE HELPFUL?

YesNo



READ THIS NEXT


 * Yes the Bubonic Plague Is Still Around, Why You Don’t Need to Worry
   
   A hunter in China was diagnosed with bubonic plague Saturday after catching
   and eating a wild rabbit, triggering concerns that the plague — which…
   
   READ MORE
   
 * 10 Natural Ingredients That Repel Mosquitoes
   Medically reviewed by Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC
   
   Most commercial bug repellents can cause health and environmental problems.
   Learn about natural repellents that actually work.
   
   READ MORE
   
 * Flea Infestations
   Medically reviewed by Vincent J. Tavella DVM, MPH
   
   Learn about flea infestations, including what causes an infestation, how to
   control an infestation, and how to prevent another infestation from…
   
   READ MORE
   
 * Lyme Disease Transmission: Can It Spread from Person to Person?
   Medically reviewed by Gerhard Whitworth, R.N.
   
   There's no direct evidence that Lyme disease is contagious. However, some
   research suggests this may be worth a closer look.
   
   READ MORE
   
 * Worst Foodborne Illness Outbreaks in Recent U.S. History
   Medically reviewed by Judith Marcin, M.D.
   
   Food poisoning causes millions of illnesses and thousands of deaths in the
   U.S. every year. Learn about some of the worst foodborne outbreaks in…
   
   READ MORE
   
 * Listeria Outbreak Linked to Cheese Leads to Recalls from Trader Joe's, Costco
   
   A listeria outbreak that has led to 26 illnesses has been connected to a
   cotija and queso fresco cheese. Rizo-López Foods has chosen to voluntarily…
   
   READ MORE
   
 * Overview of Spontaneous Bacterial Empyema
   
   Spontaneous bacterial empyema is an infection of fluid in your pleural cavity
   in the presence of a fluid build-up around your lungs.
   
   READ MORE
   







GET OUR WELLNESS NEWSLETTER

Filter out the noise and nurture your inbox with health and wellness advice
that’s inclusive and rooted in medical expertise.


SIGN UP

Your privacy is important to us

 * About Us
 * Contact Us
 * Privacy Policy
 * Privacy Settings
 * Advertising Policy
 * Health Topics

 * Sitemap
 * Medical Affairs
 * Content Integrity
 * Newsletters
 * © 2024 Healthline Media LLC. All rights reserved. Our website services,
   content, and products are for informational purposes only. Healthline Media
   does not provide medical advice, diagnosis, or treatment. See additional
   information. See additional information.

© 2024 Healthline Media LLC. All rights reserved. Our website services, content,
and products are for informational purposes only. Healthline Media does not
provide medical advice, diagnosis, or treatment. See additional information. See
additional information.
AboutCareersAdvertise with us

OUR BRANDS

HealthlineMedical News TodayGreatistPsych CentralBezzy