A Look into the History and Links Between the Black Plague and AIDS

It the early 1330's the world changed forever. An outbreak of Bubonic plague was raging through China, one of the largest and busiest trading nations of the world at the time. In October 1347, several Italian merchant ships returned from one of Chinas key trading ports in the Black Sea with a boat full of dying and dead. Within a matter of days the plague had spread through the city and to the surrounding countryside.

The following year the disease had spread to England and was called the "Great Mortality" the "Great Pestilence" and the "Black Death".

Each winter the disease would follow its hosts the fleas into hibernation with the rats and each spring it would renew with as much vigor as the year before. 25 Million people died between 1347 and 1352 that constituted one third of Europe's population. In an earlier epidemic during the 6th century over 100 million deaths took place over a 50 year period. Smaller outbreaks continued for centuries and larger outbreaks did not disappear totally until the 1600's.

The worst outbreak in the English epidemics broke out in London in 1665. That summer 7,000 people died each week and as many as 100,000 died before winter set in again.

People all over Europe searched desperately for an explanation. Some blamed invisible particles carried on the wind, others poisoned wells and still others blamed the Jews. The Flagellant Brahren appeared in 1349 and were identified by their white robes marked on both front and back with a large red cross. They moved across Europe from city to city in groups as large as 500 men and performed their rituals twice daily. They believed the plague to be a punishment from god for human sin and to atone they would sign hymns, sob and beat themselves with scourges studded with iron spikes. Unknown to them they helped spread the disease even further carrying it within their bodies from town to town.

There was no way for the people to avoid the rages of the plague and to deal with it they would institute a 40 day quarantine on any household that had a member with symptoms of the plague. This almost guaranteed that the entire household would be lost. Eventually entire towns and villages would fall under quarantine.

People would abandon their dying family members and try to flee the cities leaving the disease behind. There was, of course, no where to go. Bodies began to stack up in the streets as the number of dead surpassed the living.

So what exactly was this menace of mankind? What is the plague? The plague is caused by a nasty little bacterium called Yersinia pestis. Y. Pestis is a zoonotic disease which means that it is a disease of animals with accidental involvement of humans. Y. Pestis is easily destroyed by sunlight and drying, however it is also believed that it can remain viable in dry sputum, flea feces and buried bodies. When released into the air it can survive for up to an hour and can remain alive for months to years at freezing temperatures.

There are 3 main clinical forms of the plague those being Bubonic, Pneumonic and Septicemic.

Bubonic Plague is the most common type of the disease and is mainly caused by a flea bite to the leg. Its incubation period is 2 - 10 days. Symptoms of Bubonic Plague are Malaise, high fever, one or more painful and swollen lymph nodes, chills, and headache. Cervical and auxiliary lymph nodes can also be involved. Bubonic Plague can not be passed from person to person and treated with appropriate antibiotics in an uncomplicated state usually gains a response in 2 - 5 days. Terminal events are Circulatory collapse, hemorrhage and peripheral thrombosis.

Pneumonic Plague is much rarer and can be caused by complications with Bubonic Plague or on its own. It is highly contagious and spreads by droplet infection from animal to man or from man to man. Pneumonic Plague can also result if a person with Bubonic or septicemic plague goes untreated and the bacteria spread to the lungs. Incubation of Pneumonic Plague is 2-3 days symptoms however can show 1-3 days following exposure. Its symptoms are high fever, chills, headache, malaise, myalgias, cough with sputum, chest pain, and difficulty in breathing which usually occurs on the second day. Patients may have lymphadenopayth and blood tinged sputum. The disease progresses rapidly and results in dyspnea, stridor and cyanosis. Terminal events are respiratory failure, circulatory collapse and bleeding diathesis with mortality of 100% in untreated patients.

Septicemia Plague occurs when the bacteria multiply within the blood. Septicemia can be a result of complications in either Pneumonic or Bubonic plague or it can occur by itself. If it occurs on it's own it is usually due to the bite of an infected flea. Symtoms are fever, chills, prostration, abdominal pain, shock and bleeding into the skin and other organs. Septicemia does not spread from human to human. It has occurred due to accidental laboratory infections.

Left untreated, Bubonic Plague has a 50% mortality rate, where Pneumonic and Septicemic are nearly always fatal. 75% of those afflicted with Bubonic Plague will parish within a few days and out of those afflicted with Pneumonic Plague 90% will parish within 24 hours. 80% of patients with Bubonic Plague will also become septic, 5-15% develops pneumonia, and a smaller proportion develops meningitis. Out of those suffering from Bubonic Plague 10-15% can present with primary sepsis or gastrointestinal symptoms. The Y. Pestis bacteria has a P-3 level containment rating with the CDC. This puts it as one of three of the most dangerous diseases known to man.

In order to reduce the chance of death antibiotic treatment must be administered within 24 hours of the first symptoms. Streptomycin, gentamicin, tetracyclines and chloramphenicol are all effective against the plague bacteria. Antibiotic treatment for 7 days will protect people who have had direct, close contact with infected patients. Currently there is no plague vaccine available for public use within the United States however there is a short term vaccine available for persons at high risk.

Many believe the threat of the plague has all but disappeared except for the constant threat of biological weapons, this is however a misconception. The plague is alive and well and an average of 10 to 15 people in the United States each year are infected with one form or another. Globally, the World Health Organization reports 1,000 to 3,000 cases each year. Plague occurs in two regions within the United States: 1) Northern New Mexico, Northern Arizona, and Southern Colorado 2) California, Southern Oregon, Texas and far western Nevada. It is also thriving in Africa, Asia, and South America. The last urban plague epidemic occurred in Los Angeles in 1924-1925. In short an epidemic of major proportions can break out at any time within the United States and other parts of the world. The Texas Department of Health has set up an 800 number for the immediate report of any suspect cases of pneumonic or bubonic plague.

Dr. Stephen O'Brien of the National Institutes of Health in Washington D.C. set out to discover why some individuals recovered on their own from the pneumonic plague and why some individuals seemed to be totally immune. He centered his research in an English town called Eyam.

Eyam survived the plague with several instances of individuals whom even though in close contact never became ill. What he discovered was a mutation on the CCR5 molecule called Delta 32.

Delta 32 is present mainly in Caucasion. O'Brien assembled an international team to test for the presence of delta 32 and found that Native Africans, Asians and Indians lacked the mutation.

Bodies from Scandinavian graves as old as 3,000 to 4,000 years have shown this mutation when DNA tested. Scientists are unsure of what happened to cause the mutation but they are positive that it has been protecting mankind for centuries.

Studies were preformed on individuals that contained the delta 32/delta 32 mutation, where three thousand times the amount of HIV virus normally needed to infect a cell were injected into blood samples of these individuals and yet their blood remained unaffected.

Unlike other gene mutations Delta 32 seems harmless within the human body however it does appear to increase the individual's chance of contracting IBS and Hepatitis C. To be totally resistant you must have inherited the CCR5 Delta 32 mutation from both parents, however if you have received only one copy you may be able to delay the onset of HIV once you have become infected as well as the plague.

Y. Pestis and the HIV virus hijack the bodies cells in a similar manner; both use the CCR5 molecule as a coreceptor. Delta 32 effectively blocks this gateway into the body at 100% for those with two copies and 50% for those with one copy. Clinical studies since 1996 have confirmed that individuals which have inherited the mutation Delta 32 from both parents are 100% immune to both the plague and M-tropic strains of the HIV virus. They are not however immune to the T-tropic strains of HIV that use the CXCR4 molecule as coreceptor. The July 1st issue of the Journal of Acquired Immune Deficiency Syndromes suggests that the delta 32 mutation may also provide resistance not only against sexually transmitted HIV-1 but also for parental transmission.

Research is currently being done on the CCR5 Delta 32 mutation to fight the AIDs virus and further study will no doubt reveal further advantages and disadvantages of possessing either one copy or both of the mutation Delta 32.

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