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Travelers to areas where plague occurs are generally at low risk, according to CDC guidance, but risk rises with particular exposures: infected fleas, infected animal tissue or fluids, rodent-infested places, and close contact with someone who has pneumonic plague. Check current destination and local public-health guidance, then take practical steps to avoid those exposures.
Before you travel, check local guidance
Plague is caused by Yersinia pestis. Its presence and activity vary by place and time, so look up current destination-specific health information and local public-health notices before departure. Pay attention to advisories about plague cases or unusual rodent deaths, and follow local instructions about areas to avoid.
The general precautions below do not establish whether plague is currently active at a particular destination. CDC describes travelers to endemic areas as generally at low risk; simply being in an endemic country, staying in an urban hotel, or taking an ordinary trip is not the same as direct exposure. CDC’s Yellow Book guidance gives that qualitative risk characterization; it does not provide a numerical risk estimate for an individual itinerary.
Reduce flea exposure outdoors
Most human plague infections follow a bite from an infected flea or contact with infected animal tissue or fluids. CDC advises using repellent when activities such as camping, hiking, or outdoor work could expose you to fleas. Its plague prevention guidance identifies DEET-containing repellents for skin and clothing, and permethrin for clothing. CDC’s flea prevention guidance also describes 0.5% permethrin for treating clothing and gear.
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- Use a suitable repellent as its label directs. Cover exposed skin with clothing where practical.
- Apply skin repellent only as allowed by its label. Clothing treatment is not a substitute for skin-applied repellent, and the products are not interchangeable.
- If you use permethrin, follow the product label for treating clothing or gear; do not apply it to skin unless its label explicitly permits that use.
These steps can reduce flea exposure; they do not guarantee protection from infection.
Avoid rodents and potentially contaminated sites
Do not enter places with signs of rodent activity when you can avoid them. This includes rodent-infested buildings or sites, droppings, nesting material, and locations where sick or dead rodents have been seen or reported. CDC’s travel guidance specifically advises avoiding places with evidence of rodent activity, including droppings or nesting materials.
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- Take local warnings about plague activity or unusual rodent deaths seriously, and avoid the affected areas as directed.
- Do not touch sick or dead rodents or other wildlife. Ask local authorities how to report an animal carcass or handle a disposal question safely; CDC directs people with disposal questions to local health departments.
- If animal contact is unavoidable, use gloves and follow local public-health instructions.
Keep your distance from wild and stray animals
Do not feed, pet, or handle wild or stray animals. Keep pets from roaming in areas where plague occurs, and maintain flea control according to veterinary advice. CDC also advises not letting free-roaming pets sleep on beds in endemic areas. CDC’s prevention guidance provides these pet precautions; it does not endorse a particular flea-control product.
Understand how plague can spread between people
Plague does not spread through every casual encounter. Pneumonic plague can spread through infectious droplets from a person or animal with that form of the disease, but CDC says this ordinarily requires direct, close contact. Avoid close contact with someone who may have pneumonic plague and follow instructions from local health authorities or medical staff.
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Know the symptoms and get care quickly
Seek medical care immediately if compatible symptoms develop after possible exposure or travel to an area where plague occurs. Tell the clinician where you traveled, your travel dates, whether you had flea or animal contact, and whether you were near anyone who was sick. Prompt treatment matters. CDC describes symptoms and forms of plague in its signs and symptoms guidance and plague overview.
Bubonic plague
Symptoms can include fever, headache, chills, weakness, and one or more painful, swollen lymph nodes. CDC gives an incubation period of 2–8 days for bubonic plague.
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Pneumonic plague
Symptoms can include fever, headache, weakness, rapidly developing pneumonia, shortness of breath, chest pain, and cough. After inhalation, symptoms can begin as soon as one day after exposure.
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Do not self-prescribe preventive antibiotics or rely on vaccination
Routine preventive antibiotics are not recommended for travelers simply because they are visiting an area where plague occurs. CDC’s 1996 ACIP report says short-term prophylaxis should be considered only in exceptionally high-risk exposure circumstances. Because that recommendation is dated, a clinician or public-health authority should assess any specific exposure and advise on current care.
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CDC says plague vaccine is no longer available in the United States, and its prevention page notes that vaccines in development were not expected to be commercially available in the immediate future as of that page’s last update. Do not treat vaccination as standard traveler preparation.
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