Plague – Diagnosis and Treatment

Diagnosis

A doctor starts by looking at signs such as fever, chills, swollen lymph nodes (buboes), and pneumonia when making a diagnosis of plague. Exposure history is important, like recent outdoor activities, contact with sick animals, or flea bites.

These clues guide doctors toward possible plague infection, especially in areas where it still occurs. To confirm the disease, doctors usually check for Yersinia pestis in samples taken from:

• Lymph Node (Bubo) Fluid: Swollen lymph nodes are drained or sampled with a needle to look for the bacteria.

• Blood: A blood test checks for the infection, especially in septicemic plague.

• Lung Sputum: In pneumonic cases, a mucus sample from the lungs can help detect the bacteria.

• Spinal Fluid: If meningitis or other complications are suspected, a spinal tap may be done to test cerebrospinal fluid.

Other laboratory tests, such as polymerase chain reaction (PCR), immunoassays, or bacterial cultures, can identify the infection. However, due to the danger of fast progression, doctors often begin treatment against the infection before they finish lab results, especially when they strongly suspect plague. 

Treatment

Doctors usually start treatment as soon as they suspect plague. Because this disease can progress quickly and be life-threatening, early antibiotic treatment is the most important part of care.

Hospital staff provide support and monitor vital signs, especially in severe or advanced cases. They give antibiotics to fight the infection and help prevent complications.

These medicines may be given by mouth or through a vein, depending on the type and severity of the illness. Treatment usually lasts for 7 to 14 days, or longer if complications develop.

Patients with pneumonic plague may need oxygen support, breathing treatments, or more intensive hospital care. Isolation is sometimes needed, especially in pneumonic cases, to stop the infection from spreading through droplets when coughing or sneezing.

Hospital staff follow strict safety steps to protect others. Doctors also check for signs of organ damage or shock and provide fluids or other supportive treatments if needed.

Getting Ready for Your Health Visit

Steps You Can Take Before the Appointment

Before visiting a health care provider, you can take important steps to improve your care and help the team understand your situation. People should:

• List recent travel and exposures. Include trips to places where the plague is more common, or any contact with rodents, rats, dead animals, or pets that might have fleas.
• Write down symptoms. Note what signs have come up (like fever or swollen glands), when they started, and how they have changed.
• Prepare a list of medicines. Include all prescription drugs, vitamins, and supplements you take.
• Bring questions. Sample questions include:
  • What other illnesses could cause these symptoms?
  • How can the spread of infection be stopped?
  • Will isolation be needed?
  • Are other health concerns affected?
  • How long will tests take?

Tip: If you have a cough or are sneezing, wear a mask to help protect health care workers and others from infection. If there is a risk of plague, tell the care team right away about any possible flea bites, recent flea problems in the home, or cleaning tasks involving rodents or their nests.

What the Health Team Will Ask

At the appointment, the provider will want clear information to quickly find the cause and reduce risk to others. They may ask:

• When did symptoms begin?
• Has there been contact with wild animals, pet cats, or dead animals?
• Has the person had recent flea bites or problems with fleas or sanitation at home?
• Has there been recent travel to places where infected rodents or rat fleas are found?
• How severe and frequent are the symptoms?
• Is there anything that makes symptoms better or worse?
• Are there other health problems that could increase risk?

Healthcare providers also discuss prevention steps, such as controlling fleas and rodents, and answer questions about the possible use of a plague vaccine or when to notify public health groups like the CDC. Keeping clear notes and following instructions helps make the visit more useful and safer for everyone.