Travel Health Information Sheets

Updated June 2011


What is plague?

Plague is a serious bacterial illness, spread by fleas. Plague is carried by small animals, like rats. Fleas bite these infected animals and then go on to bite humans, spreading the bacteria. Plague can also caught by breathing infected respiratory droplets from people with plague or touching infected animal tissues, but this is less common.

Where is it found?

Plague is consistently reported from Africa where more than 80% of cases worldwide are reported. African countries particularly affected include the Democratic Republic of the Congo, Madagascar and Tanzania. Cases are seen in China, Mongolia, Viet Nam, Peru and the rural south-western region of the United States.  

In the past, particularly in the Middle Ages, Britain suffered catastrophic plague outbreaks. However, no British cases have been reported since 1918.

You can check NaTHNaC’s Outbreak Surveillance for reports of recent cases or outbreaks of plague worldwide.


 Map of plague risk areas

Courtesy US Centers for Disease Control and Prevention

What are the symptoms?

There are three types of plague; bubonic, which is the most common, pneumonic (lung) and septicaemic (blood poisoning). In bubonic plague, bacteria spread from the flea bite site into your lymph nodes and it can take from two to six days for symptoms to appear. These symptoms include fever, chills, headache and painful swellings; called buboes, which can break through your skin and drain pus.

With pneumonic plague, you breathe in bacteria during close contact with an infected person. This causes fever, pneumonia and breathing difficulties, including coughing up blood and lung failure.

Bacteria can also get into your bloodstream and cause septicaemia that can lead to rapid deterioration and death.  

What is my risk?

Plague is rare in travellers. The risk is higher in those who may have contact with rodents.

How do I reduce my risk?

Follow strict insect bite avoidance guidelines to prevent flea bites. Domestic animals should be treated regularly for fleas.

Avoid any contact with rats and other rodents and clear living areas of rubbish to reduce rodent populations.

If you are a health worker, carefully follow infection control guidelines when looking after anyone with suspected plague.

Is there a vaccine?

There is no vaccine to prevent plague.

Can plague be treated?

Plague can be successfully treated with antibiotics. Untreated, bubonic plague kills more than 50% of victims. The pulmonary and septicaemic types are nearly always fatal if not treated, so prompt medical attention is essential for all types of plague.