Plague and travel: where the risk is and how to protect yourself

Where plague is endemic

Plague circulates naturally in rodents and fleas in several regions of the world. Human cases occur sporadically, mostly in rural areas. Regions where the disease is most observed include:

• Madagascar and parts of Central and East Africa (such as the Democratic Republic of the Congo).
• Parts of Central Asia, China and Mongolia.
• Rural areas of Peru and Andean countries.
• The southwestern United States, in rural and semi-arid areas.

The real risk for travellers

For the average traveller, the risk is considered very low. Plague is not among the most common travel-acquired diseases and usually affects people with direct exposure to rodents, fleas or wildlife in rural settings.

Prevention measures for travellers

• Avoid contact with rodents, burrows and colonies of wild animals.
• Do not camp or sleep near areas with many rodents.
• Wear clothing that covers the skin and use insect repellent.
• Do not touch or feed wildlife.
• Check the destination's health guidance before travelling.
• Stay in clean accommodation with no signs of rodents.

After the trip

If you develop fever, a painful swelling or respiratory symptoms after travelling to a risk area, seek medical care immediately and report your destination and activities. That detail guides diagnosis and, if needed, early treatment.

Because no plague vaccine is available to the general public, travellers' protection is behavioural. National health authorities and references such as the CDC Yellow Book provide country-specific recommendations.