One of the oldest identifiable diseases known to man, plague remains endemic in many natural foci around the world. It is still widely distributed in the tropics and subtropics and in warmer areas of temperate countries. Essentially a disease of wild rodents, plague is spread from one rodent to another by flea ectoparasites and to humans either by the bite of infected fleas or when handling infected hosts. Recent outbreaks have shown that plague may reoccur in areas that have long remained silent.
Untreated, mortality - particularly from pneumonic plague - may reach high levels. When rapidly diagnosed and promptly treated, plague may be successfully managed with antibiotics such as streptomycin and tetracycline, reducing mortality from 60% to less than 15%.