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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:
- Located 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.
- Everett ED. Microbiology, pathogenesis and epidemiology of plague (Yersinia pestis infection). http://www.uptodate.com/home/index.html. Accessed June 17, 2010.
- Gage KL. Plague and other Yersinia infections. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/206594927-5/1015859897/1492/1167.html#4-u1.0-B978-1-4160-2805-5..50338-4_14426. Accessed June 17, 2010.
- Everett ED. Clinical manifestations, diagnosis and treatment of plague (Yersinia pestis infection). http://www.uptodate.com/home/index.html. Accessed June 17, 2010.
- Plague fact sheet. National Park Service. http://www.nps.gov/public_health/info/factsheets/fs_plague.htm. Accessed June 18, 2010.
- Frequently asked questions (FAQ) about plague. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/agent/plague/faq.asp. Accessed June 18, 2010.
- Information on plague. Center for Disease Control and Prevention. http://www.cdc.gov/ncidod/dvbid/plague.info.htm. Accessed June 18, 2010.
- Interregional meeting on prevention and control of plague. World Health Organization. http://www.who.int/csr/resources/publications/WHO_HSE_EPR_2008_3w.pdf. Accessed June 21, 2010.
- Plague fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dvbid/plague/qa.htm. Accessed June 21, 2010.
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