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June 2002; Revised Dec 2003

Plague Symptoms and other information is available here.

Prostration, very high fever, swollen, tender, and painful glands, chills, respiratory distress, and rapid onset are symptoms.

Historically, Plague (black death) has been a terror all by itself. Without treatment, mortality is about 60% and approaches 100% for the septicemic and pneumonic varieties. Prompt treatment is required, especially for the elderly and those in poor physical condition. The gram-negative bacillus is called Yersinia pestis, a new designation from the earlier Pasteurella pestis.

Routes of infection

Plague is usually transmitted to humans by fleas from infected rodents. The disease can be infectious in all of its forms. It is contagious in its pneumonic forms. Plague is most prevalent in summer months.

Diagnostic Tests

Stained smears and cultures can confirm a plague infection.

Progression of disease

Plague occurs in three primary forms, bubonic, septicemic, and pneumonic. Bubonic plague is most common and is characterized by swollen lymph glands (buboes) that give this form its name. Its incubation period is typically 2 to 6 days. Malaise, fever, and pain in regional lymph nodes are early signs. These progress into extremely painful, inflamed, and swollen lymph glands that may even erupt through the skin and exude puss. Hemorrhages occur beneath the skin, turning it dark and getting its name.

Septicemic plague typically does not involve lymph node enlargement. Septicemic infection causes toxicity, high fevers above 102F, convulsions, shock, and widespread tissue damage. This form is rapidly fatal unless promptly and properly treated. Pneumonic plague can occur as a primary infection or as a pulmonary extension of the bubonic form. The primary from typically begins in 2-3 days after infection with and acute onset with high fever, chills, sever headache, rapid heartbeat, rapid and difficult breathing, rapid pulse rate, and a productive cough. Both forms cause rapid and severe prostration, respiratory distress and possibly death.


Infections are treatable with antibiotics if given in time.

Some Terror Implications

Plague is harder to transmit than is Anthrax as it requires an exchange of sera where fleas are the typical carrier. If your skin is pricked by a stranger, see a doctor immediately.


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