For patients who do not receive immediate treatment, the death rate is nearly 100 percent. Unless antibiotic treatment is started within 24 hours, the patient can quickly go into shock and die. Symptoms of pneumonic plague include high fever, chest pain, cough, shortness of breath and coughing up bloody fluid or mucus. It occurs when the bacteria enter the lungs, which quickly causes a severe form of pneumonia. However, this is believed to be the form of plague most likely to result from a terrorist attack. It accounts for fewer than 14 percent of cases.
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