Plague history
Three pandemics killed tens of millions. The bacterium is the same today; what changed is antibiotics, rapid diagnosis and contact tracing.
Updated:
First Pandemic
6th to 8th century- 541-549Form unknown
Plague of Justinian
Constantinople and the Mediterranean
Death toll not reliably established
The First Pandemic reached Constantinople in 541-542 and returned in at least 18 waves until about 750. Ancient DNA shows it was an independent emergence from rodents, unrelated to the later Black Death strain.
Second Pandemic
14th to 18th century- 1346-1353Mixed forms
Black Death
Europe, Middle East, North Africa
At least a third of Europe; WHO: more than 50 million deaths
Arrived in Messina in October 1347 on Genoese ships and spread across Europe by 1350. Ancient DNA traces its source to central Eurasia, near Lake Issyk-Kul in modern Kyrgyzstan, around 1338.
- 1656-1657Bubonic
Naples and Genoa
Italy
About two thirds of both cities
One of the deadliest urban epidemics of the Second Pandemic.
- 1665-1666Bubonic
Great Plague of London
London, England
More than 100,000 deaths, about a quarter of the city
Recorded week by week in the parish Bills of Mortality, the primary record of the epidemic.
- 1720-1722Bubonic
Great Plague of Marseille
Provence, France
About 30 percent of the city
Introduced by the ship Grand Saint Antoine. Often called Europe's last major outbreak, though Messina (1743) and Moscow (1770-71) followed.
- 1770-1771Bubonic
Moscow plague
Moscow, Russia
More than 100,000 deaths
Triggered the Plague Riot of 1771 and shaped Russian quarantine policy for a century.
Third Pandemic
1855 to mid-20th century- 1855-1959Bubonic
Third Pandemic
Yunnan, Hong Kong, India and worldwide
An estimated 12 million deaths in India alone, 1898-1918
Began in Yunnan around 1855, reached Hong Kong in 1894 and was carried by steamships to every inhabited continent. Alexandre Yersin identified the bacterium in Hong Kong in 1894.
- 1900-1904Bubonic
San Francisco plague
San Francisco, USA
121 cases, 113 deaths
The first plague epidemic in the continental US. Infection spread from urban rats into wild ground squirrels by 1908, seeding today's US foci.
- 1910-1911Pneumonic
Manchurian pneumonic plague
Northeast China
About 60,000 deaths
Began among marmot trappers in Manzhouli on the Siberian border. Wu Lien-teh halted it in under four months, with masks, quarantine and cremation; his gauze mask is a precursor of the N95.
- 1920-1921Pneumonic
Second Manchurian epidemic
Northeast China
About 9,300 deaths
Wu Lien-teh's own survey counted 9,300 deaths, including about 600 Russians.
- 1924-1925Pneumonic
Los Angeles pneumonic plague
Los Angeles, USA
About 30 deaths
The last urban plague epidemic in the US and the last documented person-to-person spread there.
Antibiotic era
Since the 1940s- 1994Mixed forms
Surat and Beed
India
876 reported cases, 54 deaths
An inadequate early response and international overreaction caused an estimated US$3 billion in losses from travel and trade restrictions.
- 2003Bubonic
Oran re-emergence
Oran, Algeria
18 cases, 1 death
Algeria's first plague in more than 50 years, from a focus thought to be extinct.
- 2004-2005Pneumonic
Zobia diamond mine
Bas-Uele, DR Congo
130 suspected cases, 57 deaths
A pneumonic outbreak among workers at a reopened mine. WHO's later summary gives 134 cases.
- 2009Pneumonic
Ziketan pneumonic cluster
Qinghai, China
12 cases, 3 deaths
Traced to a marmot that had contact with the index patient's dog. 332 close contacts were isolated.
- 2017Pneumonic
Madagascar urban pneumonic epidemic
Antananarivo and Toamasina
2,417 cases, 209 deaths (1 Aug to 26 Nov)
Unprecedented in Africa: 77 percent of cases were pneumonic and it hit the capital and the main port. Isolates stayed sensitive to all recommended antibiotics.
- 2019Mixed forms
Pneumonic cases treated in Beijing
Inner Mongolia and Beijing
2 pneumonic, 2 bubonic, 1 death
A couple from Inner Mongolia was diagnosed with pneumonic plague in Beijing; genomics traced the infection to local reservoirs.
- 2022Bubonic
Ituri ninth outbreak
Rethy, Ituri, DR Congo
653 cases, 7 deaths (year)
Ituri reports cases almost every week; 14 of its 36 health zones report plague each year.
Reported to WHO, 2019 to 2025
Suspected cases per year from the six countries that reported confirmed human plague (DR Congo, Madagascar, Kenya, Mongolia, China, Uganda). The 2022 peak was driven by DR Congo. The all-time WHO annual peak was 5,419 cases in 1997.
Show the data
| Year | Suspected | Confirmed | Deaths |
|---|---|---|---|
| 2019 | 327 | 163 | 65 |
| 2020 | 649 | 521 | 66 |
| 2021 | 439 | 245 | 60 |
| 2022 | 968 | 776 | 76 |
| 2023 | 548 | 300 | 79 |
| 2024 | 733 | 528 | 46 |
| 2025 | 183 | 113 | 31 |
Source: WHO Weekly Epidemiological Record 101(38), 25 Sep 2026, Table 9. The USA and Peru submitted no data for these years.
Download the outbreak list as JSON: /api/v1/history.json (CC BY 4.0). Unverifiable death tolls, such as those often quoted for the Plague of Justinian, are deliberately left out.