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Plague was a devastating disease. Three outbreaks in history wiped out whole populations. The first one spread over Europe in the sixth century A.D. that lasted for more than 50 years. The second, called the Black Death, was perhaps the most deadly outbreak the world has known. It swept over Europe in the 14th century, and more than one-quarter of the European population-25 million people-perished. The Great Plague of London in 1665 was a relatively minor outbreak. A third great epidemic raged in Asia at the turn of the 20th century. The greatest toll was in India, where there were more than 12 million deaths from 1896 to 1933.

Two types of plague, bubonic and pneumonic, can occur. The typical sign of the most common form of human plague is a swollen and very tender lymph gland, accompanied by pain. The swollen gland is called a "bubo" (hence the term "bubonic plague"). These swollen glands can be located anywhere in the body, such as the armpits, groin, or neck. Bubonic plague should be suspected when a person develops a swollen gland, sudden onset of high fever, chills, headache, and extreme exhaustion, muscle pains, and has a history of possible exposure to infected rodents, rabbits, or fleas.

The second type is called pneumonic plague and is characterized by severe cough, bloody sputum and difficulty in breathing. This type of plague can be transmitted human to human. The plague victim develops pneumonia and spreads infected droplets by coughing. An epidemic may be started this way.

Outbreaks in people occur in areas where housing and sanitation conditions are poor. These outbreaks can occur in rural communities or in cities. They are usually associated with infected rats and rat fleas that live in the home. The incubation period is 2 to 6 days for bubonic plague and 2 to 4 days for primary pneumonic plague. Areas in the U.S most likely to have cases of plague include California, Utah, Arizona, Nevada, and New Mexico. . Human plague in the United States has occurred as mostly scattered cases in rural areas (an average of 10 to 20 persons each year). Globally, the World Health Organization reports 1,000 to 3,000 cases of plague every year.

The tests for plague include cultures of the lymph nodes, sputum and blood. The mortality rate for untreated cases runs between 25 and 50 per cent, but has reached as high as 90 per cent. Until recently, little could be done for the disease. Today, however, streptomycin, when used early enough, has cut the mortality rate to 5 per cent. Chloramphenicol and tetracycline are alternative effective antibiotics.