BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuPlagueBubonic plague; Pneumonic plague; Septicemic plaguePlague is a severe bacterial infection that may cause death. Causes Plague is caused by the bacteria Yersinia pestis. Rodents, such as rats, carry the disease. It is spread by fleas.People can get plague when they are bitten by a flea that carries the plague bacteria from an infected rodent. In rare cases, people get the disease when handling an infected animal.Plague lung infection is called pneumonic plague. It can be spread from person to person. When someone with pneumonic plague coughs, tiny droplets carrying the bacteria move through the air. Anyone who breathes in these particles may catch the disease. An epidemic can be started this way.In the Middle Ages in Europe, massive plague epidemics killed millions of people. Plague has not been eliminated. It can still be found in Africa, Asia, and South America.Today, plague is rare in the United States. But it has been known to occur in parts of California, Arizona, Colorado, and New Mexico.There three most common forms of plague are:Bubonic plague, an infection of the lymph nodes Pneumonic plague, an infection of the lungs Septicemic plague, an infection of the bloodThe time between being infected and developing symptoms is typically 2 to 8 days. But the time can be as short as 1 day for pneumonic plague.Risk factors for plague include a recent flea bite and exposure to rodents, especially rabbits, squirrels, or prairie dogs, or scratches or bites from infected domestic cats. Symptoms Bubonic plague symptoms appear suddenly, usually 2 to 5 days after exposure to the bacteria. Symptoms include:Fever and chills General ill feeling (malaise) MalaiseMalaise is a general feeling of discomfort, illness, or lack of well-being.Read Article Now Book Mark Article Headache Muscle pain Seizures SeizuresA seizure is the physical changes in behavior that occurs during an episode of abnormal electrical activity in the brain. The term "seizure" is often...ImageRead Article Now Book Mark Article Smooth, painful lymph gland swelling called a bubo that is commonly found in the groin, but may occur in the armpits or neck, most often at the site of the infection (bite or scratch); pain may start before the swelling appearsBuboChancroid is a bacterial infection that is spread through sexual contact.ImageRead Article Now Book Mark Article Pneumonic plague symptoms appear suddenly, typically 1 to 4 days after exposure. They include:Severe cough Difficulty breathing and pain in the chest when breathing deeply Fever and chills Headache Frothy, bloody sputumBloody sputumCoughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract). Hemoptysis is the medical term for cough...Read Article Now Book Mark Article Septicemic plague may cause death even before severe symptoms occur. Symptoms can include:Abdominal pain Bleeding due to blood clotting problems Diarrhea Fever Nausea, vomiting Exams and Tests The health care provider will perform a physical examination and ask about your symptoms.Tests that may be done include:Blood culture Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Culture of lymph node aspirate (fluid taken from an affected lymph node or bubo) Culture of lymph node aspirateLymph node culture is a laboratory test done on a sample from a lymph node to identify germs that cause infection.ImageRead Article Now Book Mark Article Sputum culture Sputum cultureRoutine sputum culture is a laboratory test that looks for germs that cause infection. Sputum is the material that comes up from air passages when y...ImageRead Article Now Book Mark Article Chest x-ray Treatment People with the plague need to be treated right away. If treatment is not received within 24 hours of when the first symptoms occur, the risk for death increases.Antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin are used to treat plague. Oxygen, intravenous fluids, and respiratory support are usually also needed.IntravenousIntravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...Read Article Now Book Mark Article RespiratoryThe words "respiratory" and "respiration" refer to the lungs and breathing.ImageRead Article Now Book Mark Article People with pneumonic plague must be kept away from other patients and isolation procedures will be followed in the hospital. People who have had contact with anyone infected by pneumonic plague should be watched carefully and given antibiotics as a preventive measure. Outlook (Prognosis) Without treatment, about 50% of people with bubonic plague die. Almost everyone with septicemic or pneumonic plague dies if not treated right away. Treatment reduces the death rate to 50%. When to Contact a Medical Professional Contact your provider if you develop plague symptoms after exposure to fleas or rodents. Contact your provider if you live in or have visited an area where plague occurs. Prevention Rat control and watching for the disease in the wild rodent population are the main measures used to control the risk for epidemics. The plague vaccine is no longer used in the United States.Open ReferencesReferencesMead PS, Nelson CA. Plague and other Yersinia infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 296.Mead PS. Plague (Yersinia pestis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 229.AllVideoImagesTogFlea - illustration Different types of fleas prefer specific animals as hosts, but will infest humans if their specific hosts are unavailable. Fleas can carry plague and typhus. They are also thought to transmit several other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) FleaillustrationFlea bite - close-up - illustration Fleas are blood-feeding insects. Pain and itching results from an allergic reaction to the materials that the fleas inject into the skin at the time of the bite.Flea bite - close-upillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationFlea - illustration Different types of fleas prefer specific animals as hosts, but will infest humans if their specific hosts are unavailable. Fleas can carry plague and typhus. They are also thought to transmit several other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) FleaillustrationFlea bite - close-up - illustration Fleas are blood-feeding insects. Pain and itching results from an allergic reaction to the materials that the fleas inject into the skin at the time of the bite.Flea bite - close-upillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationRelated Information Insect bites and stings(Injury)Fleas(Condition)Community-acquired pneumonia in adults(Condition)Cough(Symptoms)Septicemia(Condition)Pneumonia(In-Depth) Review Date: 6/20/2021 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. 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