Plague Home > Is the Plague a Health Problem Today?

The plague has killed millions of people throughout history, but is the plague a health problem today? Worldwide, 1,000 to 3,000 cases are reported each year. In the United States, most cases occur in the Southwestern and Pacific states. Plague regularly occurs in Madagascar, as well as in South America, in the Andean mountain region and Brazil. Plague is not a health problem today in Australia or Europe.

Is the Plague a Health Problem Today in the United States?

In the United States, the last urban plague epidemic occurred in Los Angeles between 1924 and 1925. Since then, human plague in the United States has occurred as scattered cases in rural areas (an average of 10 to 20 people are infected each year).
Most human cases of plague in the United States occur in:
  • Northern New Mexico
  • Northern Arizona
  • Southern Colorado
  • California
  • Southern Oregon
  • Far western Nevada.
Rock squirrels and their fleas are the most frequent sources of human infection in the Southwestern states. As for the Pacific states, the California ground squirrel and its fleas are the most common source.

Is the Plague a Health Problem Today Outside the United States?

Worldwide, there are 1,000 to 3,000 cases of plague each year. During the 1980s, epidemic plague occurred each year in Africa, Asia, or South America. Epidemic plague is generally associated with domestic rats. Almost all of the cases reported during the decade were rural. They occurred among people living in small towns and villages or in agricultural areas, rather than in larger, more developed towns and cities:
  • In Asia and extreme southeastern Europe, plague is distributed from the Caucasus Mountains in Russia through much of the Middle East, eastward through China, and then southward to Southwest and Southeast Asia, where it occurs in scattered, localized foci. Within these plague areas, there are isolated human cases and occasional outbreaks. Plague regularly occurs in Madagascar, off the southeastern coast of Africa.
  • In Africa, plague locations are distributed from Uganda south, along the eastern side of the continent, as well as in southern Africa. Severe outbreaks have occurred in recent years in Kenya, Tanzania, Zaire, Mozambique, and Botswana, with smaller outbreaks in other East African countries. Plague has also been reported in scattered areas of western and northern Africa.
  • In South America, active plague areas exist in two regions: the Andean mountain region (including parts of Bolivia, Peru, and Ecuador) and Brazil.
There is no plague in Australia. There is no plague in Europe; the last reported cases occurred after World War II.
(Click Bubonic Plague Pictures to see a map of plague distribution in animals and humans.)
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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