Primary Pneumonic Plague

• Incubation Period- 2-4 days with range of 1-6 days.
• Symptoms-
• Acute onset of fever, chills, malaise, and myalgias associated with progressive lethargy.
• A productive cough of copious watery mucoid sputum that may be bloody. Associated chest pain and increasing dyspnea. Hemoptysis is a classic sign that should suggest plague in the appropriate clinical context, but sputum may be watery or purulent.
• Gastrointestinal symptoms may be prominent with pneumonic plague; these include nausea, vomiting, diarrhea, and abdominal pain.
• A cervical bubo is infrequently present.