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Symptoms
By Mayo Clinic staffThere are three types of plague: bubonic, septicemic and pneumonic. Signs and symptoms vary depending on the type of plague. It's possible to develop more than one type.
Bubonic plague
Signs and symptoms of bubonic plague generally appear within two to eight days of a plague-infected fleabite. After you're bitten, the bacteria travel through your lymphatic system, infecting the first lymph node they reach. The resulting enlarged lymph node (bubo) is usually 1 to 10 centimeters in diameter, swollen, painful and warm to the touch. It can cause so much pain that you can't move the affected part of your body. The bubo usually develops in your groin, but may also appear in your armpit or neck, depending on where the flea bit you.
Signs and symptoms of bubonic plague include:
- Buboes — swollen, painful, warm lymph nodes
- Sudden onset of fever and chills
- Headache
- Fatigue or malaise
- Muscle aches
Septicemic plague
Septicemic plague occurs when plague bacteria multiply in your bloodstream. If septicemic plague occurs as a complication of bubonic plague, buboes may be present.
Signs and symptoms include:
- Fever and chills
- Abdominal pain, diarrhea and vomiting
- Bleeding from your mouth, nose or rectum, or under your skin
- Shock
- Blackening and death of tissue (gangrene) in your extremities, most commonly your fingers, toes and nose
Pneumonic plague
Pneumonic plague — which can occur as a complication of another type of plague or by inhaling infectious droplets coughed into the air by a person or animal — is the least common form of plague. But it's also the most rapidly fatal. Early signs and symptoms, which generally occur within a few hours to a few days after inhaling contaminated droplets, include:
- High fever
- Weakness
- Signs of pneumonia, including chest pain, difficulty breathing and a cough with bloody sputum
- Nausea and vomiting
Pneumonic plague progresses rapidly and may cause respiratory failure and shock within two days of infection. If antibiotic treatment isn't initiated within a day after signs and symptoms first appear, the infection is likely to be fatal.
When to see a doctor
Call your doctor if you or someone close to you develops signs or symptoms of plague within a week of any of the following:
- Being exposed to sick or dead rats, wild rabbits, squirrels and other rodents or to domestic cats that may have been exposed to such animals
- Being bitten by a flea
- Spending time in an area with a known, recent plague outbreak or with a large number of dead or dying animals
- Having close contact — within six feet — with a person or animal with pneumonic plague
- Traveling to a high-risk region of the United States or another country with high plague rates
