Cure for black plague



Health experts recommend antibiotics if you have been exposed to wild rodent fleas during a plague outbreak in animals, or to a possible plague-infected animal. Because there are so few cases of plague in the United States, experts do not recommend taking antibiotics unless it’s certain a person has been exposed to plague-infected fleas or animals.


Currently, there is no commercially available vaccine against plague in the United States.


The National Institute of Allergy and Infectious Diseases (NIAID) conducts and supports research on the diagnosis, prevention, and treatment of infections caused by microbes, including those that have the potential for use as biological weapons. The research program to address biodefense includes both short- and long-term studies targeted at designing, developing, evaluating, and approving specific tools (diagnostics, drugs, and vaccines) needed to defend against possible bioterrorist-caused disease outbreaks.

For instance, NIAID-supported investigators sequenced the genome of the strain of Y. pestis that was associated with the second pandemic of plague, including the Black Death. This will provide a valuable research resource to scientists for identifying new targets for vaccines, drugs, and diagnostics for this deadly pathogen.

NIAID-funded scientists have developed a rapid diagnostic test for pneumonic plague that can be used in most hospitals. This will allow health care providers to quickly identify and isolate the pneumonic plague patient from other patients and enable health care providers to use appropriate precautions to protect themselves.

Many other plague research projects at NIAID are focusing on early-stage vaccine development, therapeutics, and diagnostics. Y. pestis bacterium is a high priority with funded efforts ranging from basic science research to final product development.

Current research projects include:

  • Identifying genes in Y. pestis that infect the digestive tract of fleas and researching how the bacteria are transferred to humans
  • Studying the disease-causing proteins and genes of Y. pestis that allow the bacteria to grow in humans and learning how they function in human lungs

NIAID is also working with the U.S. Department of Defense, the Centers for Disease Control and Prevention, and the U.S. Department of Energy to:

  • Develop a vaccine that protects against inhalationally acquired pneumonic plague
  • Develop promising antibiotics and intervention strategies to treat and prevent plague infection

Related Links

Government Links

Centers for Disease Control and Prevention
1600 Clifton Road NE
Atlanta, GA 30333
1-800-311-3435 or 404-639-3534

Non-government Links

World Health Organization
Avenue Appia 20
CH-1211 Geneva 27

SOURCE: U.S. National Institutes of Health, National Institute of Allergy and Infectious Diseases (NIAID)


Bacterial Infections 101: Types, Symptoms, and Treatments See Slideshow

Bubonic Plague Symptoms and Treatment

Inflamed lymph nodes are the most common symptom of this infectious disease.

Bubonic plague is the most common type of plague — an infectious disease caused by bacteria known as Yersinia pestis.

The disease, which affects the lymphatic system (lymph nodes, ducts, and vessels), makes its way to people through bites from fleas, which acquire the bacteria by biting rodents that carry it (such as squirrels, prairie dogs, and rats).

There have been several bubonic plague pandemics throughout history, most famously the “Black Death” of the 1300s.

That medieval outbreak killed up to 60 percent of the European population, according to the Centers for Disease Control and Prevention.

Bubonic Plague Symptoms

When Y. pestis bacteria enter the body, they infect the nearest lymph node, causing it to become swollen, tender, and painful.

The bacteria can then travel through the lymphatic system, resulting in more inflamed lymph nodes (or buboes, from which bubonic plague gets its name) — particularly in the groin, armpits, and neck.

Other symptoms, which tend to develop within three to seven days of the initial infection, include:

  • Fever and chills
  • Headache
  • Malaise (general ill feeling)
  • Weakness
  • Muscle pain
  • Seizures

Bubonic Plague Complications

Left untreated, bubonic plague can spread from the lymphatic system to the bloodstream or the lungs, causing septicemic (blood) or pneumonic (lung) plague.

In addition to the symptoms of bubonic plague, septicemic plague can cause:

  • Abdominal pain
  • Circulatory shock (a life-threatening condition in which the vital organs of the body stop working)
  • Nausea and vomiting
  • Bleeding into the skin and other organs

It can eventually lead to gangrene, in which the skin and other tissues — particularly the fingers, toes, and nose — turn black and die.

Pneumonic plague causes severe pneumonia (lung infection) symptoms, such as:

  • Cough
  • Breathing problems
  • Chest pain
  • Bloody sputum (a mixture of saliva and mucus produced when you cough)

As it progresses, pneumonia from plague can cause respiratory failure and shock.

In rare cases, plague can spread to the central nervous system and cause meningitis, which is an inflammation of the membranes around the brain and spinal cord.

Ultimately, plague can cause death. In all, 30 to 60 percent of plague cases result in death if left untreated, according to the World Health Organization.

Diagnosing Bubonic Plague

To find out if you have bubonic plague, your doctor will begin by inspecting your buboes and determining whether you have any other symptoms of the disease.

Your doctor will also most likely ask you about the specific timing of your symptoms, any recent insect bites, and places you’ve recently traveled.

If plague is still suspected at this point, a fluid sample will be taken from one of your swollen lymph nodes. It will be inspected for Y. pestis using either a microscope or culture tests that allow the bacteria to grow.

Your doctor may also conduct similar tests on your blood. In the early stages of bubonic plague, the bacteria usually can’t be detected in the blood using a microscope, but culture tests may still effectively show the bacteria.

Blood tests are also used to diagnose septicemic plague, while pneumonic plague is diagnosed by performing culture tests on your sputum and saliva or mucus in your throat.

Bubonic Plague Treatment

If you have plague, it can rapidly get worse and become life-threatening, so your doctor will begin treatment immediately after your diagnosis.

Plague can usually be successfully treated with various antibiotics, including:

  • Streptomycin
  • Gentamicin
  • Levofloxacin
  • Ciprofloxacin
  • Doxycycline
  • Moxifloxacin
  • Chloramphenicol

If you don’t have plague but have recently been exposed to someone with the disease (within the past week), your doctor may give you a “post-exposure prophylaxis” dose of doxycycline or ciprofloxacin to prevent you from getting it.

Yes, bubonic plague—the Black Death that killed millions in the Middle Ages— is still out there. It even infects and kills people in the United States. Without treatment, half the people infected die, but the Food and Drug Administration approved ciprofloxacin in 2015 to treat plague, and it has just successfully been used to stop the infection in five people.

Before ciprofloxacin was approved for use, people infected with Yersinia pestis, the plague-causing bacteria, were treated with streptomycin or doxycycline. Streptomycin kills the bacteria, but has serious side effects, and doxycycline inhibits the bacteria, but doesn’t completely kill it.

Humans usually get plague after being bitten by a rodent flea that is carrying the Y. pestis bacteria. Rock squirrels, wood rats, ground squirrels, prairie dogs, chipmunks, mice, voles, and rabbits also can become infected with plague from a flea bite, and fleas that bite them can, in turn, transmit the infection to humans by biting them.

A plague-infected rat flea. Image by Dr. Pratt/CDC

After being bitten with a plague-carrying flea, the infection starts suddenly with fever, headache, chills, and weakness, accompanied by one or more swollen, tender, and painful lymph nodes, called buboes—hence, the name bubonic plague.

In some people, the bacteria travels through the blood, and septicemic plague develops. Fever, chills, extreme weakness, abdominal pain, shock, and bleeding into the skin and other organs are symptoms of septicemic plague. Skin, particularly on the fingers, toes, and nose, may turn black and die—the characteristic symptom we associate with the plague.

Either bubonic or septicemic plague can occur after a bite with an infected flea, but septicemic plague may also develop from handling an infected animal, especially if someone has contact with their blood.

Yet another form of plague, pneumonic plague, may develop from untreated bubonic or septicemic plague that spreads to the lungs, or from from inhaling infectious droplets from another person with pneumonic plague.

People with pneumonic plague develop fever, headache, weakness, and pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Pneumonic plague is the most serious form of the disease—90% of untreated people die—and it’s the only form of plague that can be spread from person to person.

And several people in the US have contracted pneumonic plague by breathing in droplets from infected cats.

Of the patients recently treated with ciprofloxacin, four had bubonic plague and the fifth had pneumonic plague. They were given ciprofloxacin for 10 days at a dose of about 15 mg/kg body weight twice daily (the maximum does for adults was 750 mg twice daily).

Three patients were sick enough to be admitted to the hospital, and two were treated as outpatients. Within two days of treatment, the patients’ body temperatures returned to normal and after two weeks, and all were discharged and returned to their normal activities.

A child in Idaho contracted the plague last year, leaving many wondering how the plague exists in the 21st century.

The disease dates back to the Middle Ages, when it killed millions in a Europe, before the age of antibiotics. At the time, they did not realize the plague was carried by the fleas who lived on rats.

Although the idea of the plague sounds dire, another “black death” is not coming. The plague, in spite of its lethal reputation, is not uncommon in the U.S. and it is usually no longer a death sentence.

According to the Center for Disease Control and Prevention, the plague was first introduced in the U.S. in 1900 by rat-infested steamships. It is most common in the western U.S.

What is the plague?

The plague is caused by a bacteria called Yersinia pestis, which is transmitted by fleas. Infected fleas spread the infection to animals, commonly mice, squirrels, prairie dogs and even cats and dogs. Humans get the plague through direct contact with infected animals or fleas.

In the U.S., people can contract the plague when disposing of squirrels or mice that died from the infection or traveled to an area where infected animals live. Human-to-human transmission is extremely rare.

How common is the plague?

Since 2000, the CDC has received reports of one to 17 cases of the plague per year. In 2015, 16 cases of plague were reported and, in 2016, there were only 4 cases.

The plague is most prevalent in Africa and is also found in Asia and South America. In 2019, two patients in Beijing, and one patient in Inner Mongolia, were diagnosed with the plague, according to the Chinese Center for Disease Control and Prevention.

In the U.S., the areas where the plague is more common include northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon and western Nevada.

What are symptoms?

The plague can cause three different types of infections.

The most common type is the bubonic plague, which represents 80 to 95 percent of cases. The symptoms include fever, chills, weakness, and headache, followed by very painful and swollen lymph nodes, referred to as “buboes.” They usually start two to six days after exposure.

When the plague gets into the blood, it can cause the septicemic plague, which represents 10 to 20 percent of cases, and triggers the entire immune system to fall into a dangerous condition called “sepsis.”

Much less common is the pneumonic plague, which can occur when a bubonic or septicemic plague is not treated and a person’s lungs become infected. It can also be spread through the air from infected humans or animals and can be fatal.

How is it treated?

The plague is a very serious illness, but is treatable with antibiotics, usually taken for seven to 14 days. Left untreated, people can still die from the plague.

How is it prevented?

One of the ways to avoid the plague is to prevent contact with infected fleas by wearing repellent during activities such as camping, hiking, working outdoors.

Avoid sick or dead animals and wear gloves when handling or skinning potentially infected animals.

Keep pets from running loose in areas where the plague is common, regularly treat pets for fleas and take sick animals to the vet right away.

To avoid attracting infected rodents, keep foods in rodent-proof containers.

People that may have been exposed to the plague by being within about six feet of a person or animal who has contracted the infection, can also take preventive antibiotics.

Plague Disease (Black Death)

What Causes the Plague?

The bacterium (Yersinia pestis) that cause plague can be transmitted from a host such as a rat to a human through the bite of an animal or insect (such as a flea). These bites transport the zoonotic disease. The animal or insect that spreads the disease is referred to as a vector. More than 200 different rodents and other species can serve as hosts. Hosts can include domestic cats and dogs, squirrels, chipmunks, marmots, deer mice, rabbits, hares, rock squirrels, camels, sheep, and other animals.

The vector is usually the rat flea. Thirty different flea species have been identified as vectors of the plague. Other vectors of plague include ticks and human lice. Transmission can also occur when someone inhales plague-infected organisms that have been released into the air. Plague can be aerosolized, as in acts of terrorism, causing the inhalation (pneumonic) form of the disease. People infected with pneumonic plague can also transmit airborne plague through coughed droplets of their own respiratory fluid. Close contact with plague-infected tissue or fluid can also transmit plague-causing bacteria to humans.

  • Types of plague:
    • Bubonic plague: The bacteria that cause plague can thrive and grow in the flea’s esophagus. This crowding of bacterial growth prevents food from entering the flea’s stomach. To overcome starvation, the flea begins a blood-sucking rampage. Struggling to swallow, the flea vomits the plague-causing bacteria into the victim’s skin during a bite. The germs invade nearby lymph glands in the bitten animal and produce an inflamed lymph node called a bubo. The plague spreads along the lymph system to every organ. In rare cases, plague spreads to the covering of the brain. Severe illness follows. Bubonic plague has a 13% death rate in treated cases and a 50%-60% death rate if left untreated. Bubonic plague is the most common form of plague.
    • Pneumonic plague: Direct inhalation of the plague-causing germs results in pneumonic plague. Severe illness follows. The death rate for the pneumonic form of plague is 100% if not treated within the first 24 hours of infection. Plague bacteria may be released into the air as a weapon of biological warfare or terrorism causing this type of the disease, or plague may be transmitted person to person through the inhalation of droplets coughed from the lungs of a person with pneumonic plague. Transmission through direct contact is rare.
    • Septicemic plague: This form of serious disease may occur quickly and causes severe blood infection throughout the body (primary). It is difficult to diagnose early because there are no buboes or lung abnormalities. This type of plague can also develop from one of the other types of plague (secondary). Septicemic plague has a 40% death rate in treated cases and about 100% in untreated cases.
  • Risk factors: The following conditions may increase the likelihood of a person contracting a plague infection.
    • Living in a rural area, especially in areas where plague is common
    • Having contact with sick animals, dead animals, small rodents, or other possible hosts
    • Participating in wilderness activities (such as camping, hiking, sleeping on the ground, hunting)
    • Exposure to flea bites
    • Exposure to naturally occurring plague in the community
    • Employment as a veterinarian
    • Outdoor activity during the summer months
  • Travel: Anyone who has traveled recently in the southwestern and Pacific Coast regions of the U.S., particularly in New Mexico, Arizona, California, and Utah, might have had a flea bite. Although contracting plague while visiting another country is rare, doctors may suspect that a flea might have bitten a patient with plague-like symptoms who have recently traveled abroad to areas where plague is present.
  • Animal contact: Close contact with infected animals and travel through rural areas are risk factors for contracting plague. Historically, rats have been the principal hosts of the plague. Currently in the U.S., ground and rock squirrels are the most common hosts. In recent years, the domestic cat has emerged as a prominent host of fleas that transmit the plague to veterinarians.

New strains of the Black Death could emerge

“Plague that killed millions is able to rise from the dead,” warns The Independent after a new study looked at the genetic history of the Yersinia pestis bacteria.

Plague is a devastating disease which causes rapid death if left untreated. There have been three plague pandemics in recorded history. The most famous was the second – the “Black Death” of the 14th to 17th centuries in Europe.

There was a smaller pandemic in the 19th and 20th centuries. However, little is currently known about the genetics of the first pandemic in recorded history – the “Plague of Justinian” of 6th–8th centuries AD.

This was reported to have killed around 100 million people, and is seen by many historians as contributing to the fall of the Roman Empire and the onset of the Dark Ages.

Using DNA extracted from the teeth of two people who died at the time of the Plague of Justinian, researchers found it was a caused by strain unrelated to the Black Death.

The fact the first two pandemics were caused by two independent strains of Y. pestis demonstrates how fresh strains could be passed into human populations today.

Before you run for the hills, plague can be now be effectively treated with antibiotics.

It is important never to be complacent. Understanding the different strains of bacteria that have caused pandemics in the past is important for planning for possible future pandemics and antibiotic development.

Where did the story come from?

The study was carried out by a large collaboration of researchers from a number of different international research institutions and was funded by McMaster University, Northern Arizona University, Social Sciences and Humanities Research Council of Canada, Canada Research Chairs Program, US Department of Homeland Security, US National Institutes of Health, Australian National Health and Medical Research Council.

One of the study participants had a financial conflict of interest involved in the work – he had financial interests in one of the companies that produces genetic scanning equipment used during the study. However, it is difficult to see how this could lead to any bias in reporting or analysis.

The study was published as an open access article in the peer-reviewed medical journal, The Lancet Infectious Diseases. This means it is freely available .

You won’t be surprised that UK headline writers went to town with this story, with dire warnings of the “Black Death striking again”. In fact, the Black Death has never gone away – there are still occasional outbreaks in the developing world such as the type that occurred in Madagascar at the end of 2013.

The actual reporting in the media did acknowledge that we have antibiotics to treat plague, and this may lessen the spread and deaths compared with the past – but you can be sure that the bleak yet inaccurate headlines will have sold more newspapers.

What kind of research was this?

The research was largely a laboratory and computer-based exercise looking to understand the strain of the plague bacteria Y. pestis that caused the Plague of Justinian. Researchers then wanted to know how it related to the strains of the bacteria that caused two other major plague pandemics, and to modern day strains of Y. pestis.

Y. pestis is a bacteria carried on the fleas of rodents, including rats. There are many varieties of Y. pestis, only some of which manage to transfer into humans, and only some of which cause disease or pandemics. The fact that rodents continually carry these bacteria-containing fleas is often referred to as a “disease reservoir”, in the acknowledgement that a strain harmful to humans may emerge.

Plague infections still occur in humans today, predominately in African and Asian countries. Plague can be treated with modern antibiotics, but these must be given as soon as possible to prevent serious illness or possible death.

By analysing the plague bacteria’s DNA, and noting differences and similarities, scientists can tell if the same or similar bacteria strain was involved in different plague pandemics at different periods in history. This is akin to a kind of genetic family tree of germs.

You can work out whether the same strain keeps re-emerging over the centuries, or whether new strains are created each time. This is important for developing treatments and strategies to reduce the impact of any future possible outbreaks (known as “pandemic preparedness”).

What did the research involve?

The researchers’ extracted DNA from the plague-causing bacteria Yersinia pestis from the teeth of two German people who died at the time of the Plague of Justinian. They analysed the bacteria DNA in the lab and compared it using a large computer database to the bacterial DNA known to have caused the two other pandemics so see how similar they were.

Radiocarbon dating of the two individuals placed them in the timeframe of the first pandemic (533AD and 504AD).

What were the basic results?

The researchers’ main finding was that the strain of Y. pestis from the Plague of Justinian period had a distinct history from all known modern day strains they compared it against. This meant it was either completely distinct and had died out, or it still existed somewhere but no one had yet recorded it in modern times.

As well as having a distinct history to modern day Y. pestis strains, the ancient bacteria was also distinct from the Y. pestis responsible for the two subsequent Black Death pandemics. This showed there was a lack of shared ancestry between the two pandemic strains, indicating the three pandemics weren’t the re-emergence of the same strain at different times.

How did the researchers interpret the results?

The authors’ interpretation was that “Y. pestis lineages that caused the Plague of Justinian and the Black Death 800 years later were independent emergences from rodents into human beings. These results show that rodent species worldwide represent important reservoirs for the repeated emergence of diverse lineages of Y. pestis into human populations.”


This study improves the understanding of the family tree of the plague-causing bacteria Yersinia pestis. It indicated the first plague pandemic was caused by a strain of Y. pestis distinct from the histories of all modern strains of the bacteria, and of the bacteria that caused two subsequent plague pandemics. This type of genetic evidence is persuasive so the conclusions are likely to be reliable.

There are two main interpretations of the results. First, the bacteria that caused the Plague of Justinian came into existence then died out. Second, the bacteria strain that caused the Plague of Justinian remains in existence, but scientists just don’t know about it, so it didn’t show up in their comparisons. The first option is probably more likely but is debateable.

The researchers mention that it is not clear why the Y. pestis lineage associated with the Plague of Justinian eventually died out.

As the researchers suggest, the fact that the causes of the first and second pandemics were two independent strains passed from rodents to humans demonstrates how rodents can act as reservoirs for diverse strains of the plague bacteria. And theoretically, these new strains could be passed into human populations today.

Because of its relative absence in developed nations, there is a false belief that plague has been eradicated, but this is not the case. Plague infections do still occur in humans today, predominately in African and Asian countries. Despite being potentially fatal, plague can now be effectively treated with prompt antibiotics. Understanding the different strains of bacteria that have caused pandemics in the past is important for planning for possible future pandemics and antibiotic development.

This study does reinforce the importance of combatting the increasing problem of antibiotic resistance. If we use antibiotics incorrectly now, such as not completing a full course of antibiotics as prescribed, or using them for conditions that would have got better anyway without the need for treatment, we could end up powerless if a new dangerous and deadly strain of the plague did emerge.

Read more about the NHS Antibiotic Resistance Campaign

Analysis by Bazian
Edited by NHS Website

Links to the headlines

Return of the Black Death: Plague that killed millions is able to rise from the dead

The Independent, 28 January 2014

1,500-year-old plague victims shed light on disease origins

The Guardian, 28 January 2014

Discovery of plague bacteria shows Black Death could return

The Times, 28 January 2014

Strain of bubonic plague as deadly as the Black Death ‘could return to Earth’

Daily Mirror, 28 January 2014

Daily Mail, 28 January 2014

Black Death ‘Could Strike Again’ Warning

Sky News, 28 January 2014

Scientists find bubonic plague ‘could strike again’

ITV News, 28 January 2014

Scientists find deadliest pandemics were caused by same plague

The Daily Telegraph, 28 January 2014

Strain of BUBONIC PLAGUE as lethal as the BLACK DEATH could return without warning

Daily Star, 28 January 2014

Links to the science

Wagner DM, Klunk J, Harbeck M, et al.

Yersinia pestis and the Plague of Justinian 541–543 AD: a genomic analysis

Lancet Infectious Diseases. Published online January 28 2014


Online Q&A
October 2017

What is plague?

Plague is an infectious disease found in some small mammals and their fleas. People can contract plague if they are in bitten by infected fleas, and develop the bubonic form of plague. Sometimes bubonic plague progresses to pneumonic plague, when the bacteria reaches the lungs. Person-to-person transmission is possible through the inhalation of infected respiratory droplets of a person who has pneumonic plague. Common antibiotics are efficient to cure plague, if they are delivered very early, because the course of the disease is usually rapid.

  • Fact sheet on plague

What are the types of plague and how do people become infected?

There are two main forms of plague infection, depending on the route of infection: bubonic and pneumonic. All forms are treatable and curable if detected early enough.

  • Bubonic plague is the most common form of plague globally and is caused by the bite of an infected flea. Plague bacillus, Y. pestis, enters at the bite and travels through the lymphatic system to the nearest lymph node where it replicates itself. The lymph node then becomes inflamed, tense and painful, and is called a “bubo”. At advanced stages of infection the inflamed lymph nodes can turn into open sores filled with puss. Human to human transmission of bubonic plague is rare. Bubonic plague can advance and spread to the lungs, which is the more severe type of plague called Pneumonic plague.
  • Pneumonic plague – or lung-based plague – is the most virulent form of plague. Incubation can be as short as 24 hours. Any person with pneumonic plague may transmit the disease via droplets to other humans. Untreated pneumonic plague, if not diagnosed and treated early, is fatal. However, recovery rates are high if detected and treated in time (within 24 hours of onset of symptoms).

What are the symptoms of plague?

Symptoms typically include sudden onset fever, chills, head and body aches and weakness, vomiting and nausea. Painful and inflamed lymph nodes can also appear during bubonic plague. Symptoms of the pneumonic form appear quickly after infection (sometimes less than 24 hours), and include severe respiratory symptoms such as shortness of breath and coughing, often with blood-tainted sputum.

How does pneumonic differ from bubonic plague?

Bubonic plague is the most common form of plague, but cannot be easily transmitted between people. Some people with bubonic plague will develop pneumonic plague, meaning the infection spreads to their lungs. Pneumonic plague can be transmitted between people through coughing. Bubonic plague has a mortality rate of 30% to 60%, while the pneumonic form is fatal in the absence of treatment. Both types have good recovery rates if people are treated in time.

How can I protect myself from being infected with plague?

To prevent the spread of pneumonic plague, avoid close contact (under 2 meters) with someone who is coughing, and reduce time spent in crowded areas. To prevent bubonic plague, do not touch dead animals and wear insect repellent while in plague endemic areas.

What should I do if I suspect I have plague?

In case of sudden symptoms of fever, chills, painful and inflamed lymph nodes, or shortness of breath with coughing and/or blood-tainted expectoration, people should immediately contact a medical provider for an evaluation. (Travellers who have left plague-affected areas should inform their health worker of their travel history to a plague-affected area.) People should avoid self-medication, including using antibiotics, unless they are diagnosed by a health worker.

How do you diagnose plague?

Health workers make an evaluation based on symptoms. Confirmation is based on laboratory testing from a sample of blood, sputum (fluid coughed up from inside the lungs) or pus from a bubo.

How can plague be treated?

Plague can be treated with antibiotics, and recovery is common if treatment starts early. In areas where there is a plague outbreak, people with symptoms should go to a health centre for evaluation and treatment. Patients with pneumonic plague must be isolated and treated by trained medical staff wearing personal protective equipment.

If I am in an area with an active plague outbreak, should I wear a mask to protect myself?

It depends on your level of exposure to sick people. People living in communities where there is a plague can wear masks if they wish, but masks must be used and disposed of properly so they do not become a source of infection themselves. Masks may help to reduce the spread of pneumonic plague if they are used correctly by people who are sick (to reduce the spread of droplets), and by health care workers (to protect themselves).

Do dead bodies spread plague?

The body of someone who has died after being infected with plague can infect people who are in close contact, such as those who are preparing the body for burial. The source of infection is the bacteria that are still present in body fluids.

Bubonic plague, the deadly scourge that wiped out half of Europe during the Middle Ages, still lurks in pockets of the globe, new research suggests.

Although plague is now rare in Europe, it recently sickened more than 10,000 people in Congo over a decade, and cases still occasionally emerge in the Western United States, according to a study published Sept. 16 in the American Journal of Tropical Medicine and Hygiene.

The plague bacteria, Yersinia pestis, had lain dormant in China’s Gobi Desert for centuries. But in the 1300s, it emerged with a vengeance, fanning out via trade routes from Asia to Europe and killing millions of people along the way. The plague was transmitted by fleas harbored by rats, which flourished in the overcrowded, filthy cities of the Middle Ages. By the end of the 1500s, between a third and half of Europe’s population had died from the Black Death.

Even during the 1900s, the plague still killed millions of people, but since then, the advent of better hygiene in cities and swift treatment with antibiotics has reduced this erstwhile killer into a rare disease.

Still present

Still, plague outbreaks still flare up around the world.

According to the new study, which tallied the reported cases of plague around the world between 2000 and 2009, more than 20,000 people became infected during that time. People contracted the disease via rodents, bad camel meat and sick herding dogs, the report said. Cases in Libya and Algeria re-emerged after decades of absence.

The biggest burden was in Africa: in Congo 10,581 people contracted plague, followed by Madagascar with 7,182 cases and Zambia with 1,309 cases.

“These events, although showing progress, suggest that plague will persist in rodent reservoirs mostly in African countries burdened by poverty and civil unrest, causing death when patients fail to receive prompt antimicrobial treatment,” the authors wrote in their paper.

In the United States during that time period, 56 people contracted the plague and seven died. The cases occurred mainly because plague has become endemic in squirrels and wild rodents in the American West. Two of the fatalities were scientists: one who had conducted an autopsy on a wild mountain lion, and another who worked with plague bacteria in the lab.

Despite being a hotbed of plague in times past, Europe logged very few cases of the disease in the past decade. That may be because European cities keep their rodent populations in check, so the potential hosts for plague aren’t as prevalent, the researchers said.

Follow Tia Ghose on Twitter and Google+. Follow LiveScience @livescience, Facebook & Google+. Original article on LiveScience.

Bubonic plague: Third case reported in China

According to Chinese officials, doctors have recently diagnosed a third case of bubonic plague in a month. Although the plague is life threatening, it is treatable. The latest outbreak should not inspire panic.

Share on PinterestPlague is transmissable via fleas infected with Y. pestis.

The most recent case concerns a 55-year-old male who appears to have caught the plague from a wild rabbit that he had killed and eaten. This occurred in the Inner Mongolia Autonomous Region.

The local health agency have published a press release explaining that the male — from Xilingol League — is receiving treatment, and that 28 people who had been in close contact with him are in quarantine. At this stage, these people have not exhibited any symptoms.

This case follows two others that Chinese officials made public on November 12, 2019. These cases also occurred in Xilingol League.

Bubonic plague, which the bacterium Yersinia pestis causes, is infamous due to historical pandemics. Today, however, it is treatable using a range of antibiotics — as long as the treatment begins swiftly.

Untreated plague is fatal in around 50–60% of cases.

Then and now

In the 1300s, bubonic plague killed around one-third of the people in Europe. Otherwise known as Black Death, it was one of three major pandemics involving the plague.

Though many people consider bubonic plague a disease of antiquity, humans have never wiped it out entirely. In the United States, for instance, there are around seven cases of the plague each year.

The bacterium first arrived in the U.S. on rat infested boats arriving from Asia in 1900.

The last U.S. plague epidemic occurred in Los Angeles, CA, in the 1920s. Y. pestis has since moved from city rats to rural rodents, and it is in rural areas that the majority of cases now occur.

In particular, these areas include northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon, and far western Nevada.

Further afield, outbreaks of the plague have occurred in Africa, Asia, and South America. Since the 1990s, most cases have occurred in Africa, and nearly all cases appear in small towns, villages, and agricultural regions.

What is bubonic plague?

Bubonic plague is one of three types of the plague. It results from infection with the bacterium Y. pestis. Most commonly, Y. pestis is spread by infected fleas that live on small animals.

Symptoms include fever, headache, and vomiting. People with the infection will often have buboes, which are painful swellings in the lymph nodes of the armpit, neck, and groin. If the infection goes untreated, bacteria can enter the bloodstream, causing septicemic plague.

From there, Y. pestis may reach the lungs, causing secondary pneumonic plague.

In the U.S., the first line of treatment involves intravenous antibiotics — usually gentamicin and fluoroquinolones. Treatment generally lasts for 10–14 days.

Although bubonic plague has a fearsome reputation, healthcare professionals consider pneumonic plague more contagious because it can spread more easily via coughing.

As with the U.S., China does not experience many plague outbreaks. The last substantial outbreak occurred on the Tibetan Plateau in 2009. In 2014, in the Chinese city of Yumen, officials sealed off large areas following a single death caused by bubonic plague.

In 2010–2015, there were 3,248 cases of the plague worldwide. These cases resulted in 584 deaths.

Although every death is a tragedy, comparing these numbers with those of other conditions puts them into perspective. For instance, globally, an estimated 59,000 people die from rabies each year.

Approximately 130 people die from an opioid overdose each day in the U.S., and around 150 people die each day from influenza and pneumonia.

In conclusion, although the word “plague” sends shivers running down our spines, this latest outbreak is not a reason to panic.

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