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(Pneumonic Plague; Bubonic Plague; Septicemic Plague; Pharyngeal Plague)
by Michael Jubinville, MPH
Plague is an infectious disease with an infamous past in human history. Because of its contagious nature, plague is a weapon of bioterrorism. Although it is not as common as it once was, outbreaks of plague do occur today.
Types of plague include:
Plague is treated with isolation and antibiotics.
Plague is caused by specific bacteria.
Bubonic and septicemic plagues are spread by bites from infected fleas. Transmission can also occur when a person comes in contact with infected tissue or bodily fluids from another person or animal.
Pneumonic plague is spread by droplets in the air when an infected person coughs or sneezes. The disease is transmitted to another person when the droplets are inhaled. Transmission by droplets is the only way pneumonic plague spreads among people.
Risk Factors TOP
Factors that may increase your chance of plague include:
Pneumonic plague may cause:
Bubonic plague may cause:
Septicemic plague may cause:
Complications of plague include shock, organ failure, and death.
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may ask about the possible source of exposure.
Your bodily fluids will be tested. This can be done with:
Images may be taken of your lungs. This can be done with a chest x-ray.
Starting antibiotics early is important. Any delay increases the risk of death. The drugs are injected in a muscle or given through a vein. Later in treatment, some drugs can be given by mouth. A person with lung symptoms will be placed in isolation to protect others. Caregivers and visitors should wear a mask, gloves, goggles, and a gown. Cases are reported to public health officials.
Supportive Care for Septicemic Plague
Health professionals will monitor those with septicemic plague for changes in status and take appropriate action. Maintaining adequate heart function, blood pressure, and oxygen supply are important.
Antibiotics may prevent infection following close contact with someone who has the disease. The drugs should be taken daily while in contact, and for 7 days after the last exposure. In addition, the caregiver and person with plague should wear masks.
In the event of a terrorism exposure, antibiotics may be given to people in the affected areas who have a fever or cough. A vaccine does not exist for pneumonic plague.
Measures to prevent naturally occurring plague include:
Centers for Disease Control and Prevention
CEPAR—Johns Hopkins Office of Critical Event Preparedness and Response
Public Health Agency of Canada
Inglesby TV, Dennis DT, Henderson DA, et al. Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 2000;283(17):2281-2290.
Plague. Centers for Disease Control and Prevention website. Available at:
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Updated March 3, 2015. Accessed June 10, 2015.
Plague. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116252/Plague. Updated September 8, 2015. Accessed September 14, 2016.
Last reviewed May 2016 by David L. Horn, MD
Last Updated: 6/20/2014
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