A health care provider will likely make a probable diagnosis of plague based on:

  • Symptoms.
  • Possible exposure to the disease during recent outdoor activity or travel.
  • Contact with a dead or sick animal.
  • Known flea bite or known exposure to rodents.

Treatment will likely start while your provider waits for the results of one or more laboratory tests to identify the Yersinia pestis bacteria. Samples for tests may come from:

  • Fluid from buboes.
  • Blood.
  • Mucous from the lungs.
  • Fluid surrounding the brain and spinal cord.


Treatment for plague begins as soon as the health care provider suspects the disease. Treatment is typically done in the hospital. Antibiotics that may be used include the following:

  • Gentamicin.
  • Doxycycline (Monodox, Vibramycin, others).
  • Ciprofloxacin (Cipro).
  • Levofloxacin.
  • Moxifloxacin (Avelox).
  • Chloramphenicol.

Preparing for your appointment

Plague symptoms are sudden and serious. If you are coughing or sneezing, you should wear a mask.

You will likely go to an emergency room. If plague is suspected, you'll see a specialist in infectious disease.

What you can do

If you are helping a person with plague-like symptoms, you can prepare for the appointment by taking the following steps:

  • Report any relevant travel or possible exposure to rodents or dead animals.
  • Write down any symptoms, including when they started.
  • Make a list of all medications, vitamins and supplements.
  • Write down questions to ask the health care provider.

If plague is a possible diagnosis, you might ask the following questions or ask them on behalf of the sick person:

  • What are other possible causes for the symptoms or condition?
  • What is the best course of action?
  • How long will it take to confirm a diagnosis?
  • Will I need to be in isolation?
  • I have other health conditions. How can I best manage them together?

Don't hesitate to ask any other questions.

What to expect from your doctor

Your provider is likely to ask several questions, including:

  • When did you begin experiencing symptoms?
  • Have you recently traveled to areas where plague is common?
  • Have you recently handled wild animals or pet cats?
  • Have you handled any dead animals?
  • Are you aware of being bitten by fleas?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
April 20, 2023
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  2. Plague: Frequently asked questions. Centers for Disease Control and Prevention. https://www.cdc.gov/plague/faq/index.html. Accessed Feb. 9, 2023.
  3. Plague. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/plague. Accessed Feb. 9, 2023.
  4. Nelson CA, et al. Antimicrobial treatment and prophylaxis of plague: Recommendations for naturally acquired infections and bioterrorism response. MMWR Recommendations and Reports. 2021; doi:10.15585/mmwr.rr7003a1.
  5. Stout J. Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection). https://www.uptodate.com/contents/search. Accessed Feb. 9, 2023.
  6. Bennett JE, et al. Plague (Yersinia pestis). In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Feb. 9, 2023.
  7. AskMayoExpert. Plague. Mayo Clinic; 2022.
  8. Plague: Map and statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/plague/maps/index.html. Accessed Feb. 10, 2023.
  9. Knoop KJ, et al., eds. Gangrene. The Atlas of Emergency Medicine. 5th ed. McGraw Hill; 2021. https://accessmedicine.mhmedical.com. Accessed Feb. 13, 2023.
  10. Plague: Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/plague/prevention/index.html. Accessed Feb. 9, 2023.
  11. Brunette GW, et al., eds. Environmental hazards & other noninfectious health risks. In: CDC Yellow Book 2020: Health Information for International Travel. Oxford University Press; 2017. https://wwwnc.cdc.gov/travel/page/yellowbook-home-2020. Accessed Feb. 13, 2023.


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