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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

Currently, plague is treated with antibiotics. The following antibiotics have been used to successfully treat plague if the person's disease has not yet overwhelmed the body's defenses (earlier treatments have a better chance to stop the disease):

• Streptomycin
• Gentamicin (Garamycin)
• Chloramphenicol
• Tetracyclines (Sumycin)
• Fluoroquinolones

Patients who are suspected of being exposed to plague should be treated immediately. The antibiotic, route of administration (IV or oral), duration of treatment and supportive care, if necessary, are determined by the patient's caregiver and usually in consultation with CDC or infectious-disease specialists. Plague is rarely seen in the U.S. (about 13 infections are diagnosed per year with one recent year with 40 diagnosed); however, about 14% of people who are diagnosed in the U.S. still die from the disease. The World Health Organization estimates about 2,900 individuals per year are diagnosed with plague currently.

The prognosis of untreated plague is poor. About 50%-90% of infected individuals will die if untreated. Even with appropriate treatment, about 14% of treated patients will still die from the disease. Those patients who recover may have sustained damage to one or more organs such as the lungs.

The CDC provides the following preventive recommendations related to zoonosis diseases caused by rodents and their vectors, including plague:

• Watch for plague activity in rodent populations where plague is known to occur. Report any observations of sick or dead animals to the local health department or law-enforcement officials.
• Eliminate sources of food and nesting places for rodents around homes, work places, and recreation areas; remove brush, rock piles, junk, cluttered firewood, and potential food supplies, such as pet and wild animal food. Make your home rodent-proof.
• If you anticipate being exposed to rodent fleas, apply insect repellents to clothing and skin, according to label instructions, to prevent flea bites. Wear gloves when handling potentially infected animals.
• If you live in areas where rodent plague occurs, treat pet dogs and cats for flea control regularly and not allow these animals to roam freely.
• Health authorities may use appropriate chemicals to kill fleas at selected sites during animal plague outbreaks.

Prophylactic (preventive) antibiotics: Health authorities advise that antibiotics be given for a brief period to people who have been exposed to the bites of potentially infected rodent fleas (for example, during a plague outbreak) or who have handled an animal known to be infected with the plague bacterium. Such experts also recommend that antibiotics be given if a person has had close exposure to a person or an animal (for example, a house cat) with suspected plague pneumonia. People who must be present in an area where a plague outbreak is occurring can protect themselves for two to three weeks by taking antibiotics. The preferred antibiotics for prophylaxis against plague are the tetracyclines or the sulfonamides. There is no commercially available vaccine against plague available in the U.S.