Bubonic Plague: Could "The Black Death" Happen Again?

Almost everyone is familiar with the Bubonic Plague, also known as "The Black Death," that in five years, killed one third of Europe's population, approximately 25 million people. And even after the Bubonic Plague had claimed millions, smaller outbreaks of the plague continued for centuries. It was not until the 1600s, that the Bubonic Plague began to disappear, and even then, citizens were constantly fearful that "The Black Death" might return.

The Bubonic Plague was also known as "The Pestilence." It is believed to have gotten its start in China and Southeast Asia, in the early 1330s, and then "The Black Death" spread rapidly throughout Europe. By October 1347, traders and Chinese railroad workers on merchant ships, unknowingly, brought infected rats from China to Italy. Many of the sailors got ill and died, and it was only a matter of days before the Bubonic Plague swept through the city and rural areas. Soon Italians were forbidden to come into certain cities, due to fear of the Bubonic Plague. There was no medicine that could cure the Bubonic Plague, which caused horrible sores on the skin that were first red, and later turned black. It also caused swollen lymph glands that were called buboes, hence the name Bubonic Plague.

Europeans were particularly vulnerable to Bubonic Plague, due to their crowded living conditions, and poor hygiene and sanitation. Imagine so many people with fever and chills, vomiting blood, aching all over, and grotesquely deformed by horrid sores and swollen lymph glands. Thank goodness the Bubonic Plague often brought a relatively quick death! (Though not quick enough, I'm sure.)

The whole world was in a panic. Family members deserted each other because of fear of the Bubonic Plague, lawyers refused to come into homes to prepare wills (for those dying of the Bubonic Plague), and people were even afraid to bury the dead. They often left them in their abandoned homes, rather than risk exposing themselves to the Bubonic Plague. The period from the onset of the infection until death by the plague, was generally less than one week.

The original source was infected rodents, whose fleas spread the Bubonic Plague to people. The bacteria associated with "The Black Death" is called Yersinia Pestis, and it still exists. When a person is bitten by a flea, that carries this bacteria, they can become very sick, and even die as a result. Rats and other rodents, around the world, still often carry the Bubonic Plague. The last urban epidemic of the plague, in the United States, occurred in Los Angeles in 1924-1925. Since then, the plague occurs sporadically in the U.S., with an estimated 10-20 cases per year. However, the World Health Organization documents about 1,000-3,000 occurrences of plague per year.

But could a deadly outbreak of the Bubonic Plague ("The Black Death"), or something similar, threaten our population today? Sadly, the answer is yes. The antibiotics that were once effective against "The Black Death", are no longer as viable. And because the early symptoms of the Bubonic Plague (and the Pneumonic Plague) are very similar to the flu, precious time can be lost in the diagnosis of the disease. Bubonic Plague is spread through the bite of an infected flea, but a highly transmittable form of the plague, called Pneumonic Plague, is rapidly spread from human to human, and if treatment is not administered within 24 hours, the antibiotics will not be effective against it. This type of the plague can be spread through coughing, sneezing, or even breathing. When untreated, Pneumonic Plague is 100% deadly.

According to Tina Blue, in her research paper entitled, "Bubonic Plaque--Yesterday's Scourge and Tomorrow's?", approximately 200 species of rodents around the world are still carriers of the Bubonic Plague. Wild rodents often pass the plague to domestic rodents, in cities, who then pass it to humans, through infected fleas. World wide air travel increases the chances that a disease (such as the plague) can be carried from one place to another quickly and easily. Rats and other rodents are becoming increasingly resistant to previously useful chemicals, used in population control. DDT is not as effective, in the control of fleas, as it once was. Agencies that monitor outbreaks of the plague, are in need of funds, and nations have become rather complacent about the dangers. As mentioned before, antibiotics aren't as powerful against plague bacteria. In fact, in 1995, a case of human plague was discovered, that exhibited a resistance to all known antibiotics. When this occurs, other similar bacteria will often also demonstrate a resistance as well. It doesn't take a rocket scientist, to figure out how quickly this could become a regional or worldwide disaster. Another factor in a potential outbreak of Bubonic Plague could be our ventures into rainforests, jungles, and wilderness areas that have previously been undisturbed. Dormant bacteria may be stirred up, as pristine areas are invaded.

An example of how Pneumonic Plague could have spread rapidly in modern times, is found in the October, 2007 story of Eric York, a biologist at the Grand Canyon National Park, in Arizona. According to USA Today, York studied the movements of mountain lions, and collared them with tracking devices. When one of the lion's collars sent out a mortality signal (noting that the animal had not moved in 24 hours), York found the carcass and took it back to his home, to determine why it died. Since the park did not have a forensics lab, he did the autopsy on the floor of his garage. (Approximately 2, 000 park employees lived in the village where the procedure was done.)

Medical experts surmise that when he cut into the mountain lion, "a cloud of bacteria emerged", and he breathed it in. He was found dead November 2, and after further research, was declared to be a 21st century plague victim. Both the lion, and 37 year old York, were found to have Pneumonic Plague. Since the park is home to more than 5 million visitors a year, public health experts were concerned that an epidemic of Pneumonic Plague might break out. So they enlisted the CDC, the National Park Service, and the Arizona Department of Health to check out the park. They were looking for dead rodents that might have fleas, that could bite other animals or humans, (resulting in the Pneumonic Plague), but they found no such evidence. They also were relieved to find that York had only come in contact with 49 people in the interim, between contracting the Pneumonic Plague infection and dying. No one became sick, and they were all treated with antibiotics. But you can clearly see the implications, if all had not gone well. Since Pneumonic Plague is an infection of the lungs, that can quickly spread by coughing or sneezing, many people could have easily been infected. Researchers report, that even with treatment, this type of plague is often fatal, with a death rate as high as 50%.

Since York never suspected Pneumonic Plague, when he visited the park clinic, he was diagnosed with the flu, and sent home. He was tragically discovered dead, by a roommate, 3 days later. This caused the National Park Service to begin a program of working with the CDC, as well as local health departments, in attempting to identify possible diseases (such as Pneumonic Plague) that might be a danger to park visitors, and those that they could come in contact with, after leaving the park.

So, in closing, we are at risk for Bubonic Plague, Pneumonic Plague, and other plagues, due to resistant antibiotics, global spread of infection through air travel, ineffective chemicals to control rodents, disturbance of pristine jungles, rainforests, and wilderness areas, and overcrowded living conditions, with improper sanitation. Come to think of it, after researching this article, I'm getting really nervous about those squirrels that live in our attic...

Sources: http://www.cdc.gov/ncidod/dvbid/plague/index.htm

http://www.cdc.gov/ncidod/dvbid/plague/qa.htm

http://www.cdc.gov/ncidod/dvbid/plague/diagnosis.htm

http://www.cdc.gov/ncidod/dvbid/plague/info.htm

http://www.cdc.gov/ncidod/dvbid/plague/prevent.htm

http://www.themiddleages.net/life/blackdeath.html

http://www.themiddleages.net/plague.html

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http://www.usatoday.com/news/health/2008-10-21-plague-grand-canyon_N.htm