Almost all of the approximately 3000 annually reported cases of plague
in the world occur in African countries: Botswana, Kenya, Madagascar, Mozambique, Tanzania, and Zaire.
A few cases are seen in other parts of the world. The U.S. has 10-15 cases per year, usually in CO, UT, NM, and AZ. Europe has not had plague since WWII. Australia also does not have plague.