Plague: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Plague?
An infectious disease doctor, a doctor who treats illnesses caused by germs, usually treats plague. Plague needs treatment right away, so you may first see an emergency room doctor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is plague?
Plague is a severe infection caused by a germ called Yersinia pestis. It affects small mammals, mainly rodents such as rats, and it also affects people.
Plague is rare in the United States. An average of about 7 cases happen each year. Most human cases have happened in Africa. Plague can be treated, and it is usually cured if it is caught early.
Symptoms
There are three types of plague.
Bubonic plague is an infection of the lymph nodes, which are small glands that help fight germs. It is the most common type in the United States. Symptoms start suddenly, usually 2 to 8 days after exposure. They include:
- Fever and chills.
- A generally ill feeling, a headache, and muscle pain.
- Painful, swollen lymph glands called buboes. They are most often in the groin, but they can be in the armpits or neck.
Septicemic plague is an infection of the blood. It can happen after a flea bite or from handling an infected animal. It can also develop from untreated bubonic plague. Symptoms can include:
- Fever, chills, and extreme weakness.
- Belly pain, nausea, vomiting, and diarrhea.
- Shock, and bleeding into the skin and organs.
- Skin that turns black and dies on the fingers, toes, and nose.
Pneumonic plague is an infection of the lungs. It is the most serious form. It is the only type that spreads between people. Symptoms start suddenly, usually 1 to 3 days after exposure. They include:
- A severe cough and fever with chills.
- Trouble breathing and chest pain.
- Weakness and a headache.
- Frothy, bloody sputum, which is the mucus you cough up.
Causes and who gets it
Rodents such as rats carry the plague germ, and fleas spread it. People can get plague in three main ways:
- A bite from a flea that carries the germ. Dogs and cats can also bring infected fleas into the home.
- Touching an infected animal's body fluid or tissue. For example, a hunter who skins an infected animal could get sick.
- Breathing in tiny droplets from an infected person or animal. This causes pneumonic plague.
In the United States, most cases happen in rural areas, mainly in northern New Mexico and Arizona, southern Colorado, California, southern Oregon, and western Nevada.
You can lower your risk in places where plague occurs. Remove brush, rock piles, and clutter around your home so rodents have fewer places to live. Wear gloves when you handle or skin animals that may be infected. Use repellent if you may be around fleas outdoors, and follow the label. Keep fleas off your pets with flea control products.
How doctors diagnose it
Your doctor will do a physical exam and ask about your symptoms. Tests may include a blood culture, which grows germs from a blood sample. Doctors may also test fluid taken from a swollen lymph node, test sputum, or take a chest x-ray.
Treatment should start if plague is suspected, even before test results come back.
Treatment
Plague is treated with antibiotics, which are medicines that kill bacteria. People with plague need to be treated right away. If treatment does not start within 24 hours of the first symptoms, the risk of death goes up. Doctors may use ciprofloxacin, doxycycline, gentamicin, levofloxacin, moxifloxacin, or streptomycin.
Oxygen, fluids through a vein, and breathing support are usually needed too. A person with pneumonic plague is kept away from other patients in the hospital. People who had close contact with that person are given antibiotics as a precaution and watched closely.
When to see a doctor
Plague is a serious illness. Get medical care right away if you have plague symptoms after contact with fleas or rodents. Do the same if you live in or have visited a place where plague occurs.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain that lasts two minutes or more, or you cough up blood.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do a first exam, ask about animal or flea contact, and send you to emergency care or an infectious disease doctor if plague is possible.
Common questions
Is plague still around today?
Yes, but it is rare. In the United States, an average of about 7 cases happen each year, mostly in rural areas.
Can plague be cured?
Yes, plague can usually be cured if it is caught early. Antibiotics are the treatment. They must start right away, because the risk of death goes up if treatment is not received within 24 hours of the first symptoms.
Can plague spread from person to person?
Only pneumonic plague, the lung form, can spread from person to person. It spreads when someone breathes in droplets from the cough of an infected person.
Is there a vaccine for plague?
No, a plague vaccine is not available in the United States. New vaccines are being developed, but they are not expected to be sold soon. Lowering your contact with rodents and fleas is the best way to protect yourself.
Sources
- MedlinePlus - Plague
- Centers for Disease Control and Prevention - Signs and Symptoms of Plague
- Centers for Disease Control and Prevention - Preventing Plague
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
