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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Plague facts
• What is plague?
• What is the history of the plague?
• What causes plague?
• How is plague spread?
• What are plague symptoms and signs?
• How is plague diagnosed?
• What is the treatment for the plague? What is the prognosis of the plague?
• How can plague be prevented?
• Is there a vaccine against plague?
• What research is being done on plague?
• Where can more information be found on plague?
• Plague Index

The symptoms of plague can be progressive; however, most investigators break the symptoms into three different groups because plague is often described in three types; bubonic, septicemic, and pneumonic. A patient can also present with the symptoms of only one type of plague. Untreated plague may show progressive symptoms that can overlap; however, the following will describe those symptoms and signs that predominate during the three general types of plague:

• Bubonic: In about three to seven days, lymph nodes become swollen, tender, and are termed buboes (the term bubonic is derived from buboes) and the patient may also develop fever, chills, and weakness.
• Septicemic: In general, septicemic plague patients do not develop buboes; instead symptoms may include fever, chills, weakness, bleeding under the skin, abdominal pain, and septic shock with low blood pressure. Septicemic plague may develop in about one to seven days after exposure.
• Pneumonic: In about one to three days after the person is exposed to airborne droplets that contain Y. pestis, shortness of breath, cough (sometimes with bloody sputum), and chest pain quickly develop along with weakness, fever, and headaches.

Untreated bubonic plague may progress and produce symptoms of both septicemic and pneumonic plague, while septicemic plague may progress to produce pneumonic plague. However, pneumonic plague is the most serious and lethal form of plague, and while the patient may develop septicemic symptoms, the pneumonic symptoms are the most serious. Nonetheless, all three plague types can be fatal to a patient.

Figure 2: Picture of an inguinal bubo in a patient with plague. SOURCE: CDC/Dr. J. Lyle Conrad

Figure 3: Picture of gangrene of the hand caused by Y. pestis; digits and other skin areas that developed this gangrene helped name the plague as "the Black Death." SOURCE: CDC/Dr. Jack Poland