Plague

What is plague?

Plague is a disease caused by bacteria. People usually get plague after being bitten by infected fleas or by handling an infected animal. Rarely, a person with plague can spread the disease to others.

There are three types of plague: bubonic, septicemic, and pneumonic.

Type of Plague

How it spreads

Symptoms

Bubonic

Bites from infected fleas and handling infected animals

Fever, painful lymph, swollen, and tender lymph nodes

Septicemic

Bites from infected fleas and handling infected animals

Fever, weakness, stomach pain, and sometimes bleeding into the skin and other organs. 

Pneumonic

Contact with infected people or animals

Fever, headache, weakness, shortness of breath, chest pain, cough, bloody or watery mucous, chills

Who is at risk?

Plague is found in countries around the world, including certain regions of Africa, central Asia, the Indian subcontinent, the northern part of South America, and parts of the southwestern United States. Rare, urban outbreaks of plague have been reported in Madagascar.

Though plague is found in countries around the world, the risk to travelers is low. However, camping, hiking, or working outdoors can increase your risk.

What can travelers do to prevent plague?

There is no vaccine or medicine that prevents plague available in the United States. Travelers can protect themselves from plague by taking the following precautions

Use insect repellent

  • Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.
    • DEET
    • Picaridin (known as KBR 3023 and icaridin outside the US)
    • IR3535
    • Oil of lemon eucalyptus (OLE)
    • Para-menthane-diol (PMD)
    • 2-undecanone
  • Find the right insect repellent for you by using EPA’s search tool.

Treat clothing and gear with permethrin

  • Use 0.5% permethrin to treat clothing and gear (such as boots, pants, socks, and tents) or buy permethrin-treated clothing and gear.
    • Permethrin is an insecticide that kills or repels mosquitoes.
    • Permethrin-treated clothing provides protection after multiple washings..
    • Read product information to find out how long the protection will last.
  • If treating items yourself, follow the product instructions.
  • Do not use permethrin products directly on skin.
  • Watch the video What You Need to Know About Permethrin.

Do not touch sick or dead animals. Live fleas can jump from a dead animal onto a person.

  • If you must handle a sick or dead animal, wear gloves, cover your skin, and use additional personal protective equipment

Additional steps to take if visiting or living in an area with plague

  • Store all food in rodent-proof containers.
  • Keep rodents out of the house.
  • Protect yourself and pets
    • Do not allow pets to sleep with you.
    • Do not allow pets to roam free in known plague areas.
    • Protect your pet from fleas. Talk to a veterinarian.

stethoscope

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel. Avoid contact with other people while you are sick.

If you need medical care abroad, see Getting Health Care Abroad.

Traveler Information

Clinician Information