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Symptoms
By Mayo Clinic staffPlague is divided into three main types — bubonic, septicemic and pneumonic — depending on which part of your body is involved. Signs and symptoms vary depending on the type of plague.
Bubonic plague
Bubonic plague is the most common variety of the disease. It's named after the buboes — swollen lymph nodes — which typically develop within a week after an infected flea bites you. Buboes may be:
- Situated in the groin, armpit or neck
- About the size of a chicken egg
- Tender and warm to the touch
Other signs and symptoms may include:
- Sudden onset of fever and chills
- Headache
- Fatigue or malaise
- Muscle aches
Septicemic plague
Septicemic plague occurs when plague bacteria multiply in your bloodstream. 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 affects the lungs. It's the least common variety of plague but the most dangerous, because it can be spread from person to person via cough droplets. Signs and symptoms can begin within a few hours after infection, and may include:
- Cough, with bloody sputum
- Difficulty breathing
- High fever
- Nausea and vomiting
- Weakness
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
Seek immediate medical attention if you begin to feel ill and have been in an area where plague has been known to occur. This includes parts of several states in the western portion of the United States — primarily New Mexico, Arizona and Colorado.
- Plague. Centers for Disease Control and Prevention. http://www.cdc.gov/plague/. Accessed Dec. 21, 2012.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 21, 2012.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Dec. 24, 2012.
- Sun W, et al. Developing live vaccines against Yersinia pestis. Journal of Infection in Developing Countries. 2011;5:614.
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- FDA approves new antibacterial treatment for plague. FDA news release. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm302220.htm. Accessed Dec. 24, 2012.
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