PLAGUE : Types, Symptoms and Treatment

Plague is an infectious disease caused by a deadly bacteria called yersinia pestis which is sometimes referred to as the “Black Plague.”  These bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them, which can be contracted by other animals and humans.

Historically, plague destroyed entire civilizations. In the 1300s, the “Black Death,” as it was called, killed approximately one-third (20 to 30 million) of Europe’s population. In the mid-1800s, it killed 12 million people in China.

Today, thanks to better living conditions, antibiotics, and improved sanitation, current World Health Organization (WHO) statistics show there were only 2,118 cases in 2003 worldwide. Also the risk of developing plague is quite low, with only 3,248 cases and 584 deaths reported to the World Health Organization (WHO) from 2010 to 2015.

Yersinia pestis can affect people in three different forms, namely:

  • Bubonic plague : The most common form of plague is bubonic plague. It’s usually contracted when an infected rodent or flea bites you. In very rare cases, you can get the bacteria from material that has come into contact with an infected person. 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 : This form of plague occurs when the bacteria multiply in the blood. You usually get septicemic plague the same way as bubonic plague through a flea or rodent bite. You can also get septicemic plague if you had untreated bubonic or pneumonic plague.
  • Pneumonic plague : This is the most serious form of plague and occurs when Yersinia pestis bacteria infect the lungs and cause pneumonia. You get primary pneumonic plague when you inhale plague bacteria from an infected person or animal. You get secondary pneumonic plague if you have untreated bubonic or septicemic plague that spreads to your lungs. Pneumonic plague is the only form of the plague that can be transmitted from person.


What are the Signs and Symptoms?

According to World health organization (WHO), People infected with plague usually develop acute febrile disease with other non-specific systemic symptoms after an incubation period of one to seven days, such as sudden onset of fever, chills, head and body aches, and weakness, vomiting and nausea.

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

  • Fever and chills
  • Headache
  • Muscle pain
  • General weakness
  • Seizures

Also 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 bubonic plague its name.

Septicemic plague symptoms usually start within two to seven 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).
  • Skin turning black (gangrene).

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).


What do you do if you have plague?

Plague is a life-threatening disease. If you have been exposed to rodents or fleas, or if you have visited a region where plague is known to occur, and you develop symptoms of plague, contact your doctor immediately:

  1. Be prepared to tell your doctor about any recent travel locations and dates.
  2. Make a list of all over-the-counter medications, supplements, and prescription drugs you take.
  3. Make a list of people who have had close contact with you.
  4. Tell your doctor about all your symptoms and when they first appeared.
  5. 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.

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

  • To check for pneumonic plague, fluid will be extracted from your airways by a tube that is inserted down your nose or mouth and down your throat. This is called a bronchoscop.
  • The samples will be sent to a laboratory. A blood test can reveal if 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.
  • For analysis, preliminary results may be ready in just two hours, but confirmatory testing takes 24 to 48 hours.

Often, if the plague is suspected, your doctor will begin treatment with antibiotics 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 and Prevention of Plague

Plague is a life threatening condition that requires urgent care. If plague is suspected and diagnosed early, a health care provider can prescribe specific antibiotics (generally streptomycin or gentamycin or ciprofloxacin, intravenous fluids, oxygen, and, sometimes, breathing support). Certain other antibiotics are also effective.

If left 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.

Health experts recommend antibiotics if you have been exposed to wild rodent fleas during a plague outbreak in animals, or to a possible plague infected animal. Other preventive measures include informing people when zoonotic plague is present in their environment and advising them to take precautions against flea bites and not to handle animal carcasses.

Generally people should be advised to avoid direct contact with infected body fluids and tissues. When handling potentially infected patients and collecting specimens, standard precautions should apply.

World health organization (WHO) does not recommend vaccination, except for high risk groups (such as laboratory personnel who are constantly exposed to the risk of contamination, and health care workers).




  • Mayo Clinic – plague/symptoms-causes
  • U.S. National Institutes of Health, National Institute of Allergy and Infectious Diseases (NIAID)
  • National Library of Medicine MedlinePlus
  • Medcine Net – plague 


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