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Xenopsylla cheopis is the primary vector of plague in most large plague epidemics in Asia, Africa, and South America. Both male and female fleas can transmit the infection. Yersinia pestis is the bacterium that causes bubonic plague (the black death of the middle ages) and is primarily a flea-carried pathogen of rats. Infection is rapid, causing swelling in the lymph nodes and leading to septicemia and pulmonary infection. Extensive control measures, directed against the rats as well as their fleas, have essentially banished the plague from Europe, but there are still many regions of the world where the disease occurs.
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