(Pneumonic Plague; Bubonic Plague; Septicemic Plague; Pharyngeal Plague)


Plague is a bacterial infection.

There are 3 types:

  • Bubonic—most common
  • Pneumonic—rare, but almost always leads to death
  • Septicemic


Certain bacteria cause plague. How it spreads:

  • Bubonic and septicemic—
    • A bite from an infected flea
    • Exposure to bodily fluids from a sick person or animal
  • Pneumonic—breathing it in after a person coughs or sneezes

Spreading Pneumonic Plague

Breathing in droplets from an infected person.

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Risk Factors

Your risk is higher if you live in or travel to places where plague is common. It’s found in the southwestern and western US, and other parts of the world.

Risk is also higher if you:

  • Are in contact with a person who has plague
  • Work with animals
  • Get a flea bite



  • Fever
  • Chills
  • Weakness
  • Headache
  • Swollen, tender lymph nodes—your skin may appear red and tight over these areas


  • Fever
  • Weakness
  • Headache
  • Cough
  • Bloody or watery mucus
  • Breathing problems
  • Chest pain


  • Bleeding under the skin
  • Black fingers, toes, or nose
  • Fever
  • Chills
  • Weakness


Your doctor will ask about your symptoms, and health and travel history. You may have:

Public health officials will work quickly to find the source of plague to set up testing and care.


Antibiotics treat the infection. Care will start right away. This may include isolation.

For the septicemic type, your healthcare team will support your organs, blood pressure, and oxygen supply while your body fights the infection.


If exposed to plague, you’ll need to take antibiotics for 7 days. People who care for you will need to wear masks.

If there is a terrorist attack, medicines go to those who have signs of infection.

To help lower your chances of plague:

  • Control the number of rodents near your home, since they carry fleas.
  • Wear gloves when handling or skinning animals.
  • Use bug sprays with DEET.
  • Use flea control on your pets.
  • Keep dogs and cats from sleeping in your bed if they roam in places where the disease is common.

Centers for Disease Control and Prevention

National Institute of Allergy and Infectious Diseases


Alberta Health

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: Updated March 3, 2015. Accessed May 15, 2018.

Plague. EBSCO DynaMed Plus website. Available at: Updated September 8, 2015. Accessed May 15, 2018.

Last reviewed May 2018 by David L. Horn, MD, FACP  Last Updated: 5/15/2018