Yersinia causes three types of plague in humans: bubonic, pneumonic, and septicemic. Although there is DNA evidence that Yersinia was present in victims of the Black Death, it is uncertain which form the majority of the infection took. It is likely that all three played some role in the pandemic.

Bubonic plague causes fever, fatigue, shivering, vomiting, headaches, giddiness, intolerance to light, pain in the back and limbs, sleeplessness, apathy, and delirium. It also causes buboes: one or more of the lymph nodes become tender and swollen, usually in the groin or armpits.

Pneumonic plague affects the lungs and causes symptoms similar to those of severe pneumonia: fever, weakness, and shortness of breath. Fluid fills the lungs and can cause death if untreated. Other symptoms may include insomnia, stupor, a staggering gait, speech disorder, and loss of memory.

Septicemic plague is an infection of the blood. Its symptoms include fatigue, fever, and internal bleeding.