A pocket full of posies;
We all fall down.”
New research suggests that the Bubonic plague, aka the Black Death, the deadly scourge that wiped out half of Europe during the Middle Ages, still lurks in pockets of the globe.
In a study published Sept. 16 in the American Journal of Tropical Medicine and Hygiene, the Bubonic plague, caused by the bacteria Yersinia pestis, though rarely found in Europe, sickened more than 10,000 people in Congo over the last decade, and cases still crop up in the Western United States.
Originating in China’s Gobi Desert, the bacterium lay dormant for centuries, but in the 1300s emerged with a fury! Trade routes from Asia to Europe made for easy mobility, killing millions of people along the way. Transmission by fleas harboured by rats, which flourished in the overcrowded, filthy cities of the Middle Ages, made containment nearly impossible and by the end of 1500s nearly half of Europe’s population was decimated.
More recently, during the 1900s, the plague continued to kill millions of people. The advent of better hygiene in cities and the ability for swift treatment via antibiotics significantly reduced this killer into a rare nuisance.
The plague still exists today, however, with the World Health Organization reporting 1,000 to 3,000 cases worldwide each year, of which an average of five to 15 cases occur in the U.S. These cases are usually scattered in rural areas and caused by bites primarily from infected prairie dogs. There has not been a case of person-to-person infection in the United States since 1924.
In other parts of the world, new cases in Libya and Algeria have re-emerged after decades of absence, with people being contracted via rodents, bad camel meat and sick herding dogs.
The hardest hit in recent years has been Africa. In Congo 10,581 people contracted the plague, followed by 7,182 cases in Madagascar, and 1,309 cases in Zambia.
“These events, although showing progress, suggest that plague will persist in rodent reservoirs mostly in African countries burdened by poverty and civil unrest, causing death when patients fail to receive prompt antimicrobial treatment.”
The Plague as a Bioweapon
With chemical weapons being on the radar of strong armed global politics as of late, especially in relation to the situations in the Middle East and Syria, it is important to note that the plague often keeps the company of anthrax, smallpox and botulism as potential bioterrorism weapons.
Yersinia pestis could be sprayed through the air, infecting anyone who inhales it. In this scenario, antibiotics would treat the plague effectively if they are used soon after infection. Though there is no vaccine for the plague, with prompt treatment the overall fatality rate would be less than 15 percent. Without treatment however, mortality rates could be as high as 60 percent from the bubonic plague and 100 percent for pneumonic plague. Death would occur within days after symptoms appear.
Though the Black Death is widely attributed to the Bubonic plague, there are actually three different forms of the plague, all stemming from the facultative anaerobic, Gram-negative, rod-shaped, coccobacillus bacterium Y. pestis.
Bubonic inflames the tonsils, adenoids, spleen and thymus, inducing fever, aches, chills, fatigue and tender lymph glands. The Bubonic plague is the most common type in humans, but is rarely spread from person to person.
Septicemic, in which bacteria multiply in the blood, causes fever, chills, shock, bleeding, abdominal pain, diarrhea, vomiting, and death of tissue in fingers, toes and nose.
Pneumonic plague occurs when the bacteria enter the lungs and causes pneumonia. This can be spread between people, and kills faster than the other forms of plague. This form of the disease is the one that is feared by security officials. Symptoms include fever, nausea, vomiting, weakness, chest pain, difficulty breathing and a bloody cough.
Image: Rocky Mountain Laboratories, NIAID, NIH