The plague or the Black Death, we all probably know these terms from our history books. It is a fatal disease that killed millions of people during the Middle Ages and was one of the largest epidemics our region has ever known. However, this disease has not been eradicated unlike the victims who suffered from it. In the 20th century, this disease caused increased mortality in India and Vietnam. In the 21st century, this disease mainly occurs in animals, but can be transmitted to humans through, for example, flea bites. Most cases were identified on the continents of Africa, Asia and South America and North America.
What is the plague?
When we hear the word plague, people immediately tend to think of the bubonic plague, also known as the Black Death, which refers to the terrible outbreak of these epidemics in Europe and Asia in the 14th century. The plague is caused by the enterobacterium Yersinia pestis. The symptoms depend on the intensity of the infection on a particular part of the body. For example, bubonic plague is predominantly present in the lymph nodes, while pneumonic plague is mainly in the lungs. Septicemic plague will then infect the blood vessels.
The infection is primarily passed on through rats that carry infected fleas. So it is not the rats that carry the bacteria, but the fleas that have settled on the rats. When these fleas end up on humans, they can transfer the bacteria to the human body. However, there are also other rodents that can harbor fleas such as squirrels and rabbits. Even dogs and cats are sometimes not spared. Fleas are the ideal carriers for the Yersinia pestis bacteria. The digestive tract is blocked, causing the flea to regurgitate the bacteria and allow it to enter the host’s body.
Symptoms and types
As mentioned earlier, the symptoms of plague depend on the part of the body that is infected. This is usually the area where the flea or other carrier of the bacteria has bitten.
Bubonic plague
This will occur when the bacteria enter directly into the lymphatic system. Once present, they will multiply very quickly. Due to this enormous increase in bacteria, the immune system will have to intervene to fight the bacteria. This causes severe inflammation and massive swelling of the lymph nodes, resulting in extreme pain. These swellings are called bumps and resemble large blisters that manifest themselves in the lymphatic area, specifically the armpits, groin area and neck.
Septicemic plague
Septicemic plague occurs when the bacteria enter directly into the bloodstream, usually caused by a flea bite to a superficial blood vessel. In contrast to the lymphatic system, which could contain these bacteria, the bacteria in septicemic plague are transported via the bloodstream throughout the body. This form of plague almost always results in death. In some cases, the victim even succumbs within 24 hours.
Pneumonic plague
Pneumonic plague is different from the other types. Although it can also be caused by a flea bite, the infection usually occurs through inhalation of coughed up, infected droplets from the lungs of people already suffering from pneumonic plague. Due to its virulence and extreme ability to infect, this disease is usually fatal, especially if it breaks out in crowded, poorly ventilated buildings. Death usually occurs after three to four days from infection.
Internal bleeding occurs in all these forms of the disease. This bleeding causes bruises to black spots all over the body. Hence the name Black Death. In addition to these symptoms, plague victims also experience severe chills, fever, muscle aches, rashes, and seizures. These symptoms are in addition to:
- the painful bumps in bubonic plague
- breathing difficulties, coughing and bloody sputum in pneumonic plague,
- abdominal pain, diarrhea, nausea, vomiting, general organ failure and low blood pressure in the septicemic variant.
Today, the treatment of plague consists of modern antibiotics such as streptomycin, tetracycline and gentamicin. A vaccine is not available and is also useless during an epidemic as it may take several weeks before it is effective. General medical and nursing support is also necessary for these patients.
Risk to date
From the available information from various organizations including the WHO (World Health Organization), we can conclude that the last major plague epidemic ended in southern China at the beginning of the 20th century. This epidemic killed more than ten million people around 1920. Today, most cases of plague are reported in Africa, more specifically in Congo. Other regions where cases of plague are still regularly detected are Tanzania, Madagascar, Vietnam, Peru, China and Mongolia. Fortunately, the number of victims is no longer as extreme as during the Middle Ages and in many areas the disease is no longer present.
The most worrying thing about this disease is that it can suddenly appear in areas where it was thought to be extinct. In 2003, for example, a few cases of plague were detected in Algeria, even though the disease had not occurred in that country for more than fifty years. In fact, we can all fall victim to this disease by traveling to areas where this disease still occurs or simply through work. In London and the surrounding area, for example, people working in sewers are required to wear protective clothing and masks to reduce the risk of potentially active plague bacteria and other diseases.
Decision
The plague is one of the oldest known diseases and has claimed the lives of at least 200 million people over time. Unfortunately, this disease is not completely extinct and continues to claim victims today. Fortunately, this disease can be treated successfully if detected early.
We are already aware of several other bacteria that have become immune to antibiotics. Will the plague bacteria eventually also become resistant to antibiotics? Will we one day experience another pandemic? At this point this seems quite unlikely, but we should not underestimate the ever-changing world of bacteria, especially the Black Death. After all, bacteria of all kinds have been on this earth for much longer and have seen many other species of life come and go. Will they also witness our demise?
