One Health III Disease FactGroup

Sheet: Plague
Members:

Disease: Plague

Scientific Name: Yersinia pestis (etiologic agent)

Species involved: Fleas (Vectors), Wild Rodents/Prairie Dogs (Reservoir), Other affected species are
black footed ferrets, rabbits, cats, dogs, and humans etc.

Geographic location (s): Enzootic foci of sylvatic plague exist in the western USA and throughout the
world, including Eurasia, Africa, and North and South America.

Clinical Signs: (+/-) antemortem/postmortem lesions: In mammalian hosts, plague presents clinically in
one of three forms: bubonic, septicemic, or pneumonic. Bubonic: fever, headache, chills, weakness,
swollen lymph nodes (Cats) Septicemic: fever, chills, abdominal pain, shock, possibly bleeding into skin,
lethargy and anorexia (Cats) Pneumonic: fever, headache, weakness, rapidly developing pneumonia w/
shortness of breath, cough, chest pain (Humans)

Characteristic necropsy findings can include livers that are pale with light-colored necrotic nodules,
enlarged spleens with necrotic nodules, and lungs with diffuse interstitial pneumonia, focal
congestion, hemorrhages, and necrotic foci. Dogs infected with plague are less likely to develop
clinical illness than cats, although cases have been seen in enzootic areas.

Morbidity/mortality: Infection in all forms can be fatal unless treated immediately with antibiotics, such
as streptomycin. Mortality rates for treated individuals range from 1 percent to 15 percent for bubonic
plague to 40 percent for septicemic plague. In untreated victims, the rates rise to about 50 percent for
bubonic and 100 percent for septicemic. The mortality rate for untreated pneumonic plague is 100
percent; death occurs within 24 hours.

Diagnostic Test (s):  During acute illness, preferred antemortem samples for culture include whole
blood, lymph node aspirates, swabs from draining lesions, and oropharyngeal swabs from cats with
oral lesions or pneumonia. Diagnostic samples should be taken before antibiotics are administered.  Y
pestis F1 antigens are what you are trying to detect from the samples through different techniques.
Postmortem specimens should include samples of liver, spleen, and lung (for pneumonic cases) and
affected lymph nodes. 

Transmission: Transmitted primarily by the fleas of rats and other rodents. Domestic cats and dogs
have also been known to develop plague from oral mucous membrane exposure to infected rodent
tissues, typically when they are allowed to roam and hunt in enzootic areas. Most human cases result
from the bite of an infected flea, although direct contact with infected wild rabbits, rodents, and
occasionally other wildlife and exposure to infected domestic cats are also risk factors. Humans can
also contact with respiratory droplets from pneumonic plague patients

Treatment/Control: Untreated plague can be rapidly fatal, so early diagnosis and treatment is essential
for survival and reduction of complications. Antibiotics and supportive therapy are effective against
plague if patients are diagnosed in time. Streptomycin has been considered the drug of choice in
human cases but is difficult to obtain and rarely used today. Gentamicin is currently used to treat
most human plague cases and should be considered a suitable alternative in veterinary medicine for
seriously ill animals. Doxycycline is appropriate for treatment of less complicated cases and to
complete treatment of seriously ill animals after clinical improvement. Preventive measures include
informing people when zoonotic plague is present in their environment and advising them to take
precautions against flea bites and not to handle animal carcasses. Avoid direct contact with infected
body fluids and tissues, when handling potentially infected patients and collecting specimens, standard
precautions should apply (gloves, mask and eye protection).
One Health III Disease FactGroup
Sheet: Plague
Members:

Reference:

CDC. “Plague.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6
Aug. 2021, https://www.cdc.gov/plague/index.html

Ettestad, Paul, DVM. “Overview of Plague.” Merck Veterinary Manual, Merck Veterinary Manual, Nov.
2013, Overview of Plague - Generalized Conditions - Merck Veterinary Manual (merckvetmanual.com)

“Plague.” World Health Organization, World Health Organization,

https://www.who.int/news-room/fact-sheets/detail/plague