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1. What is plague?
2. How is plague spread?
3. Who is at risk of plague?
   
4. How is plague prevented?
5. How is plague diagnosed and treated?
6. What is the public health response?

What is plague?

Plague is a rare disease caused by the Yersinia pestis bacteria. It infects humans through bites from fleas that have also fed on infected rodents.

In the Middle Ages, millions of people died from plague because there were large numbers of infected rats and antibiotic treatment was not available.

Today, plague is uncommon and most people survive if they get antibiotic treatment quickly.

What are the symptoms of plague?

Symptoms usually occur from one to seven days after coming into contact with the bacteria.

Early symptoms include

• fever
• chills
• headache
• nausea and vomiting
  
• body aches and weakness.

There are different types of plague. Bubonic plague is the most common. It results in swelling and tenderness of the lymph node closest to the flea bite (known as a bubo).

Septicaemic plague is when the bacteria spreads to the blood. Pneumonic plague is when the bacteria infects the lungs. These cause more severe illness.

How is plague spread?

Plague is usually spread by fleas biting infected animals and then biting humans. It can also be spread through direct contact with blood, tissue or organs of infected animals. Rarely, human cases can happen by breathing in infected droplets in the air.

Who is at risk of plague?

Plague is not found in Australia. People at risk of plague are those in contact with rodents and their fleas in areas where plague is found. Wild rodent plague exists in rural parts of the Americas, Eastern Europe and Russia, Africa and Asia.

How is plague prevented?

There is no vaccine to protect against plague. Plague can be prevented by avoiding contact with fleas, rodents or other animals that carry the disease.

When travelling overseas in areas with plague:

• wear gloves if you need to handle animals that could be infected
• avoid or limit direct contact with rodents
• use insect repellent during outdoor activities (such as camping and hiking)
  
• repellents with DEET can be used on skin 
• repellents with permethrin can be used on clothing
  
• do not let dogs or cats that roam outside sleep on beds and limit contact with them where possible.

Controlling rodent populations helps lower flea numbers and reduces the risk of plague spreading to people.

How is plague diagnosed and treated?

Plague is diagnosed by identifying the Yersinia pestis bacteria from the bubo, blood, spinal fluid or sputum.

Early treatment with antibiotics is required.

What is the public health response?

Laboratories diagnosing cases of plague must notify the local public health unit. Public health units follow-up each case to determine where the person acquired the infection.

For more information, please call your local public health unit on 1300 066 055.