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Plague is a serious infection caused by the bacterium Yersinia pestis. It can be life-threatening, but prompt treatment with appropriate antibiotics can cure it. If you develop a concerning fever or other symptoms after a possible exposure—especially in a place where plague occurs—seek medical care immediately and tell the clinician about the exposure.

What is plague?

Plague is an infectious disease that affects people and other mammals. In nature, Yersinia pestis circulates among small mammals and their fleas. People most often become infected through the bite of an infected flea, and less often through contact with an infected animal.

The disease remains naturally present in parts of the western United States and in some regions of Africa and Asia. The World Health Organization’s 2026 fact sheet reports a 30%–60% case-fatality ratio for bubonic plague; that is a population-level figure, not a prediction for an individual. WHO says pneumonic and septicaemic plague are fatal when untreated, while early diagnosis and antibiotic treatment can save lives.

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What are the symptoms of the different forms of plague?

Plague has three main clinical forms. The form depends partly on how the bacteria entered the body and where the infection develops. Symptoms can overlap, and a person should not wait for a complete symptom pattern before seeking care.

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Form Where it affects the body Typical symptoms and course Transmission context
Bubonic Lymph nodes Fever, headache, chills, weakness, and one or more painful, swollen lymph nodes called buboes. CDC cites a usual incubation period of two to eight days. Without treatment, infection can spread beyond the lymph nodes. Often follows an infected flea bite; direct contact with infected animal tissue is another possible route. It is not the form associated with person-to-person respiratory spread.
Septicemic Bloodstream Fever, chills, extreme weakness, abdominal pain, shock, bleeding, or areas of tissue death, especially in fingers, toes, or the nose. It can occur as the initial form or develop from untreated bubonic plague. May arise after infection enters the bloodstream; it can follow untreated bubonic plague.
Pneumonic Lungs Fever, headache, weakness, rapidly developing pneumonia, shortness of breath, chest pain, cough, and sometimes bloody or watery sputum. CDC describes a usual incubation period of one to three days for inhalation-related infection. Can follow inhalation of infectious respiratory droplets from a person or animal with pneumonic plague. This is the form that can spread between people.

These descriptions are not a checklist for ruling plague in or out. CDC advises immediate medical attention for symptoms suggestive of plague, particularly after living in or recently travelling to an area where it occurs.

How does plague spread?

  • Infected flea bites: the most common route of human infection.
  • Contact with infected animals: bacteria can enter through handling infected tissue or contact with an infected animal’s body fluids.
  • Respiratory droplets: a person or animal with pneumonic plague can spread infectious droplets to someone in close contact.

Plague is not ordinarily spread through casual contact between people. The key person-to-person risk is close respiratory exposure to someone with pneumonic plague. Dogs and cats can bring infected fleas into homes; cats with plague can also expose owners and veterinary staff to respiratory droplets.

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How is plague diagnosed and treated?

Assessment and testing

Clinicians assess symptoms alongside possible flea, animal, travel, and geographic exposures. Laboratory testing uses patient specimens, especially blood or material from a swollen lymph node. Tell medical staff promptly about any suspected exposure so they can take appropriate precautions and contact public-health authorities.

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Prompt, clinician-directed antibiotics

Plague is treated with antibiotics. CDC’s U.S. clinical care guidance lists gentamicin and fluoroquinolones among first-line treatments and describes a typical course of 10 to 14 days, which may be extended if fever or other concerning signs continue. The specific medicine, route, and regimen depend on severity, age, health conditions, allergies, and other clinical factors; treatment should be directed by a clinician and public-health team, not attempted with leftover or self-selected antibiotics.

If plague is strongly suspected, CDC advises starting treatment after samples are collected when feasible, without waiting for final test results. Suspected cases should be reported to local and state health authorities. Patients with pneumonic symptoms need precautions to reduce droplet spread.

What happens after close exposure?

People who have been in close contact with a very ill patient with pneumonic plague may be assessed and monitored. Preventive antibiotics may be considered based on the type and timing of contact; a health professional or public-health authority should determine whether they are appropriate.

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How can you reduce the risk of plague?

  • Reduce rodent food sources and suitable habitat around homes, workplaces, and recreation areas.
  • Wear gloves when handling or skinning animals that may be infected.
  • Use flea repellent during outdoor activities where exposure is possible. CDC says products containing DEET can be applied to skin and clothing; permethrin products can be applied to clothing. Follow the product label.
  • Keep fleas off pets, seek veterinary care if a pet becomes sick, and do not let free-roaming dogs or cats in areas where plague occurs sleep on beds.

Repellents can reduce exposure risk, but they do not treat plague or replace medical evaluation after a concerning exposure. CDC states that a plague vaccine is no longer available in the United States. New vaccines are in development, but CDC does not expect them to be commercially available in the immediate future.

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When to seek medical care

Get immediate medical attention for symptoms that could be plague after a plausible exposure, including an infected flea bite, contact with a potentially infected animal, or close respiratory contact with someone who has pneumonic plague. Do not wait for symptoms to match every detail in a list, or for a test result, before seeking help. Share your exposure history with the clinician.

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