The next large town to the east of Danzig is Königsberg in the Prussian kingdom, which has so far profited from the war by taking over some of the Swedish and Polish Livonian trade.

In preparation for the plague, a Collegium Sanitatis (health commission) is set up, including physicians from the university and leading civilian and military officials of the town.

The plague arrives in August 1709, most probably carried by a Danzig sailor.

The provincial government is exiled to Wehlau while the chancellor, von Kreytzen, remains in Königsberg and continues to work as the chairman of the Collegium Sanitatis, which meets daily.

The city walls are manned by the military, the burghers are conscripted into neighborhood watches, medical and other personnel are hired, dressed in black waxed clothes and housed in separate buildings.

While at first the city authorities downplay the plague, which reaches a peak in early October and then declines, this approach is abandoned when the death toll again starts to rise significantly in November.

Without prior public announcement, a cordon sanitaire is implemented around the city, sealing it off completely from the surrounding countryside from November 14/15 until December 21, 1709.