When to seek doctor advice

Common general symptoms

• Fever
• Chills
• Body aches  
• Sore throat  
• Headache
• Weakness
• General feeling of illness
• Abdominal pain (may be the only symptom for someone with septicemia plague)
• Nausea, vomiting (sometimes containing blood)
• Constipation  , diarrhea  , and black or tarry stools
• Stomach pains (may precede a bubo)
• Cough (may contain blood)
• Shortness of breath
• Stiff neck
• Fever  , heart irregularities  , low blood pressure  
• Confusion, seizures   (later in the infection period)

Bubo: This is an enlarged, tender, swollen lymph gland most commonly found in the groin, under the arms, or on the neck, depending on the locations of the flea bite. Skin: Bleeding into the tissues can turn tissue black. This is why the plague is also referred to as black death. The medieval rhyme "black death" is thought to have originated from the deeply darkened skin, bleeding, and tissue death associated with septicemia and pneumonic plague. The initially rose-colored lesions most likely inspired the child's nursery rhyme "Ring Around the Rosy."

"Ring around the rosy" - Rose-colored areas of skin

"Pocket full of posies" - Sweet-smelling flowers that those tending the sick would carry to ward off the stench of disease

"Ashes, ashes" - Impending death (or "A-choo, a-choo" - The sneezing and coughing of those with pneumonic plague)

"All fall down" – Death

Prognosis

Patients with plague may develop meningitis   (infection and swelling of the brain), septic shock (a serious system wide blood infection), tissue death and bleeding, and swelling around the heart. All may lead to death.

• The death rate is 1-15% for those treated for bubonic plague.
• A person with primary or secondary septicemia plague (infection is active in the bloodstream and the patient has shock symptoms) has a 40% death rate, even when treated.
• Pneumonic plague has 100% death rate if not treated within the first 24 hours.

Prevention

• A previously used plague vaccine is no longer manufactured. It was only effective against the bubonic form of the illness. A new vaccine is under development.
• In general, to prevent contracting plague, people should avoid contact with wild animals. Controlling rat and flea populations where plague is found is also important.
• Anyone who has had contact with the plague-infected patient (including hospital and rescue personnel) should be watched carefully for symptoms. At the first sign of illness (such as fever or swollen glands), doctors will begin antibiotic treatment.
• Pets and people who have come into contact with a plague-infected person should be given antibiotics as a preventive measure.