The Modern Threat from Bubonic Plague

In the years surrounding 1350, one-third of Europe's population died from the Black Death. It was frightening because the people then didn't understand where it came from or how it was spread. They only knew that when people developed the black buboes, the black lumps in their armpits and groin, that those people were likely to die within a matter of days at the most, victims of the Black Death.

The plague has continued to decimate populations around the word every 250 years or so.

Rather than "the Black Death," today we call the same infection the Bubonic Plague. We know it is spread by fleas that live on rodents, rats that were common in medieval times and sometimes prairie dogs today. For some reason, prairie dogs are particularly susceptible to the plague. The plague typically wipes out an entire colony of prairie dogs, but the danger to humans isn't over. A domesticated cat, for instance, might come across the rodents and carry the disease back to humans by eating the carcasses. (Besides bites from fleas, Bubonic Plague can be transferred to humans by handling infected material, including fluids, or even inhaling droplets in the air.)

But prairie dogs actually account for few modern cases of Bubonic Plague, regardless of what ranchers in southwestern states have been told. Rabbits, mice and other rodents are also carriers of the plague if they are host to infected fleas although ticks and lice can also be hosts. The most common creature to infect people in the U.S. today is the squirrel.

Besides the black, enlarged lymph nodes, the symptoms of Bubonic Plague include expulsion of blood through vomit or urination, fever, fatigue, and extreme pain. Victims of the Bubonic Plague can develop septicemic plague, an illness of the bloodstream. Pneumonic plague, the infection of the lungs, is also a fairly common complication and is very infectious, spread by the coughing of the infected. Death is common within a few hours of those showing symptoms of the pneumonic plague. This airborne quality is what causes concern in some circles about the possibility of Bubonic Plague being used as a biological weapon, causing a recurrence of the Black Death of history.

Diagnosis must be made early in the course of the illness in order to have effective treatment. Antibiotics such as tetracyclines and streptomycin, are the ways to treat Bubonic Plague in modern medicine. Numbers vary, but sources say 50-90% of untreated cases result in death while the antibiotics drop the rate to a high of 15%.

Currently, only about a dozen cases of Bubonic Plague occur each year in the U.S. Other parts of the world are not so lucky, and as many as 2,000 such cases appear around the globe. The last epidemic in the U.S. took place nearly a century ago.

Prevention against the Bubonic Plague consists primary of rodent control. Eliminating places for rats to nest reduces the likelihood that people, their pets, or their livestock will come in contact with the disease-bearing fleas. Domesticated animals should be regularly treated with anti-flea and tick medications or collars. People should apply insect repellents when traveling outdoors, especially in areas where infected animals might be found. Those who travel out of the country to dangerous areas might consider a vaccine.

Although the catastrophic result of the Black Death of the Middle Ages is unlikely to recur, it has not been completely eradicate in the world, even in the U.S. But very basic precautions can prevent widespread outbreak of Bubonic Plague. The fear of the Black Death that gripped people from medieval Europe to citizens of Los Angeles in the early 1900s is unwarranted given advances in modern medicine and knowledge of its transmission. Sporadic deaths will doubtless continue to occur as cases are misdiagnosed or caught too late, but the pandemic known as the Black Death is no more, even as the instrument of a terrorist attack.

References

Cristin Conger. "Can I catch plague from a prairie dog?" howstuffworks.com.

Department of Health Promotion and Education. "Plague." Dhpe.org.

Medline Plus. "Plague." nlm.nih.gov.

Wikipedia. "Bubonic Plague." Wikipedia.org.