Plague

At a glance

No approved vaccine available – read more about prevention
Nationally notifiable disease

About plague

Plague is an infectious disease caused by the bacterium Yersinia pestis.

It can result in serious illness and death.

There are 3 main clinical forms of plague:

bubonic – where the bacteria infect the lymph nodes, generally the closest nodes to the flea bite
septicaemic – where the bacteria spreads to the bloodstream
pneumonic – where the bacteria infect the lungs.

Bubonic plague is the most common type.

Why it matters to public health

Plague can cause severe disease and death if not treated early.

Bubonic plague causes death in 30–60% of untreated cases. Septicaemic and pneumonic plague almost always result in death if untreated.

Plague is very rare in Australia. Australia has not had a case of plague in a person since the 1920s.

People can get infected if they travel to areas where the disease is found, including parts of Africa, Asia and the Americas.

Symptoms

If you’re looking for advice about your own health or treatment options, see healthdirect or speak with a qualified healthcare professional. Our role is to provide public health advice – information and guidance that helps prevent disease, protect communities, and improve wellbeing at a population level.

Symptoms depend on the type of plague. Common symptoms include:

fever
headaches
weakness.

Bubonic plague symptoms include swollen and painful lymph nodes (buboes).

Septicaemic plague symptoms include:

abdominal pain
bleeding into skin or organs
shock.

Pneumonic plague symptoms:

difficulty breathing
chest pain
cough (with or without blood).

Complications can include sepsis, respiratory failure and death.

Onset of symptoms

Symptoms usually start 2 to 8 days after exposure to the bacteria.

How it spreads

Plague mainly spreads from animals to people through bites from infected fleas that live on rodents.

People can also be infected through:

scratches or bites from infected animals, such as domestic cats and dogs
direct handling of infected animal tissues
breathing in air from around infected animals or people
handling samples of Yersinia pestis in laboratories, without appropriate protection.

Bubonic and septicaemic plague do not usually spread between people.

Pneumonic plague can spread between people through the air.

Infectious period

People with plague are infectious from the start of symptoms until 48 hours after starting appropriate antibiotic treatment.

Prevention

Protect yourself

There is no routine vaccination for plague in Australia.

When travelling overseas to affected areas:

avoid contact with fleas and rodents
avoid contact with animals that might be infected
avoid contact with people who are unwell
maintain respiratory hygiene
use insect repellent and wear protective clothing to prevent flea bites
do not handle sick or dead animals
keep accommodation free of fleas and rodents.

Priority groups and settings

People at greater risk of severe disease

Anyone with plague is at risk of severe disease.

People at greater risk of exposure

People might be at greater risk of being exposed to plague if they travel to or live in countries where plague occurs. The risk is likely to be higher for people who:

have contact with fleas and rodents
have contact with animals
live in rural settings.

Laboratory workers handling Yersinia pestis are also at greater risk.

Diagnosis and treatment

Plague is usually diagnosed through laboratory testing of:

blood
sputum
bubo (fluid from a swollen lymph node)
cerebrospinal fluid (fluid from around the spinal cord).

The Australian Government regulates the handling of the bacteria that cause plague. This is because of their potential to be misused in an act of bioterrorism or biocrime. Read more about security sensitive biological agents.

Plague is treated with antibiotics. Early treatment reduces the risk of severe illness and death.

Surveillance and reporting

Plague is a nationally notifiable disease – these are diseases that present a risk to public health.

Health authorities in each state and territory would report new cases to us through the National Notifiable Diseases Surveillance System.

This is part of national surveillance to monitor case numbers and disease patterns.

Outbreaks

Plague is very rare in Australia. There has not been a case of plague in a person in Australia since the 1920s.

Read more about how the Australian Government defines and plans for outbreaks.

Support

For information about plague in your state or territory, see:

If you need mental health support, see a list of organisations, websites and services that offer support, counselling and information.

For travel advice, see Smartraveller.