Plague Information

Plague is an illness caused by a type of germ (bacteria). These bacteria are usually found in fleas or in small animals such as rats and mice (rodents). Plague can affect both humans and other animals. It is a very serious illness that can lead to death if not found and treated right away.

The plague usually occurs in certain areas around the world (endemic). From time to time, the number of cases of plague may suddenly increase in one of these areas (outbreak). Plague outbreaks are reported in most years in the African country of Madagascar. These usually occur between September and April. Other places that have seen plague outbreaks in recent years include the Democratic Republic of Congo, Peru, and rural areas of the Western United States.

There are three main types of plague infection: bubonic, pneumonic, and septicemic.

How does plague spread?

Plague can spread from animals to humans through the bite of a flea that is carrying the bacteria. People can also get the plague by handling an animal that is infected with the bacteria. Household pets that are allowed to roam are at risk of coming into contact with infected animals (such as rodents) or fleas.

Pneumonic plague may spread from person to person or from animal to person if a person breathes in small particles of body fluid (respiratory droplets) from an infected person or animal.

What are the symptoms of plague?

Bubonic

Symptoms of bubonic plague include:

• Fever with chills.
• Headache.
• Weakness.
• Swollen, painful lymph nodes (called buboes).

Pneumonic

Symptoms of pneumonic plague include:

• Fever.
• Headache.
• Weakness.
• Shortness of breath.
• Chest pain.
• Cough.
• Bloody or watery mucus.

Septicemic

Symptoms of septicemic plague include:

• Fever with chills.
• Weakness.
• Abdominal pain.
• Black skin on the fingers, toes, and nose.

These symptoms can develop and become severe very quickly. Seek medical care right away if you develop these symptoms and:

• You live in or travel to an area where plague is endemic or in an outbreak.
• You have been exposed to a person or animal that is infected with plague.
• You have been exposed to a person who has been in an area with known plague cases.

How do health care providers diagnose plague?

Your health care provider will diagnose plague by testing a sample of body fluid. Such a sample may include:

• Pus from a bubo.
• Blood.
• Mucus.

How is plague treated?

If identified right away, plague can be treated with antibiotic medicines.

How can plague be prevented?

If you live in or travel to an area where plague occurs:

• Reduce rodents near places where you spend most of your time, such as home or work.
  • Remove brush, rock, and wood piles to limit areas where rodents may make a nest.
  • Remove pet and bird food to limit rodent access to food.
  • Seal holes and cracks on the outside of your home, garage, or outbuildings with sturdy material to keep rodents from coming inside.
  • Set traps or work with a pest-control company to remove rodents.
• Wear gloves when handling rodents or any animals that may be infected.
• Call the health department or animal control agency to have any dead animals removed.
• Prevent flea bites when spending time outdoors.
  • Use an insect repellent that contains at least 25% DEET. This may be applied to skin or clothes.
  • Use an insect repellent that contains permethrin. This should be applied to clothing only.
• Make sure your pets get a monthly flea prevention product.
• Do not allow outdoor pets to sleep in your bed.
• If you find fleas on your pets or in your home, treat with a flea control product right away.
• If your pet becomes sick, call your veterinarian right away.

What should I know about traveling?

• The locations of plague outbreaks change every year. To identify high-risk areas, check the CDC travel website at wwwnc.cdc.gov/travel  or follow CDC Travel Health (@CDCtravel  ) on Twitter.
• Let your health care provider know if you have plans to travel or have recently traveled to a high-risk area.

Summary

• Plague is an illness caused by a type of bacteria that is usually found in small animals and fleas. It is a very serious illness that can lead to death if not found and treated right away.
• If identified right away, plague can be treated with antibiotic medicines.
• Plague can be prevented by protecting yourself from flea bites when you live in or travel to a high-risk area. This can be done by limiting the number of rodents in your area, using insect repellent when outdoors, and treating your pets for fleas.