My daughter ordered "The Eleventh Plague" as part of her interest in dystopian worlds ("City of Embers" books and "The Hunger Games" books). As she took a break from this book, I picked it up (I liked the "Embers" and "Hunger" books, along with the old favourite "1984" by Orwell).
I can't say I got too much out of this book. It was fairly typical scavengers and isolated pods of "normalcy" - nothing particularly unique or surprising. The "City of Embers" had the whole idea that as generations went by, they didn't even realize they were underground - "Hunger Games" had the political realities and the forced Games themselves to drive home issues.
"Eleventh Plague" suffered from the main character not being defined well enough to have any deep feelings for his motivations. Further, the main confrontation, and the lead-in causes were weak and childish. The setting could have led to a more complex and meaningful confrontation (e.g. making the "leader family" more evil, which would have required more events in the book, or making the precipitating event more substantial - as it was, a childish prank caused a major repercussion).
In all, the elements of the book were OK, but the balancing was off - the familiarity with some key characters was lacking, so some of the power of the story was lost, and the town, which seemed idyllic, was apparently (and inexplicably) so unstable, that one event on one home resulted in a war-response.
Not high on my recommendation list, but I'm not particularly the target audience for the book.