Plague is a rare disease caused by bacteria that can infect people and animals. People can get plague after being bitten by infected fleas, handling an infected animal, or breathing in infectious droplets from an infected person or animal. 

Plague symptoms depend on how the patient was exposed to the bacteria. Plague can present with different clinical forms, but the most common forms in humans are bubonic, septicemic, and pneumonic plague.

Plague is found in certain regions of Africa, central Asia, the Indian subcontinent, the northern part of South America, and the Southwest United States. Though 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, hunting, hiking, or working outdoors can increase your risk.

There is no vaccine to prevent plague available in the United States. However, travelers can protect themselves from plague by taking the following precautions

Wear 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 insects.
  • 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 apply permethrin products directly to skin.
• Watch the video What You Need to Know About Permethrin.

Do not touch sick or dead animals. Infected fleas can jump from a live or dead animal onto a person. People can also become infected when handling tissue or body fluids of an infected animal. For example, a hunter skinning an infected animal without using proper precautions could become infected with plague.

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

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

• Store food, including pet food, in rodent-proof containers.
• Keep rodents out of the house and make living spaces rodent proof.
• Protect yourself and your pets
  • Do not allow pets that roam free in known plague areas to sleep on your bed.
  • Protect your pet from fleas. Talk to a veterinarian.

Plague is a very serious illness but is treatable with commonly available antibiotics. The earlier a patient seeks medical care and receives treatment that is appropriate for plague, the better their chances are of a full recovery.

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel. 

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

• Plague
• Avoid Bug Bites
• CDC Yellow Book: Plague