The plague can manifest in 3 different major forms: 1) bubonic, 2) pneumonic, and 3) septicemic. The bubonic plague begins as painful adenopathy 2 to 10 days after the infecting flea bite [41] , usually in the groin, axilla, or cervical region. A bubo is a 1-to 10-cm large, acutely swollen, erythematous, extremely painful, lymph node with surrounding edema and warmth [42] . Fever, chills, headache, and weakness occur with acute onset, and can transition to the septicemic form of the plague [42] in a quarter of patients. There are 80% of patients with the bubonic plague, which are bacteremic. There are 5 to 15% of bubonic plague victims who develop pneumonic plague, and hence become contagious. The overall mortality is estimated to be 60%, but can be less than 5% with prompt initiation of treatment.