Other Info: The Black Death

plague - any contagious, malignant, epidemic disease, in particular the bubonic plague and the black plague (or Black Death), both forms of the same
infection. These acute febrile diseases are caused by Pasteurella pestis (Yersinia pestis), discovered independently by Shibasaburo Kitasato and
Alexandre Yersin in 1894, a bacterium that is transmitted to people by fleas from rats, in which epidemic waves of infection always precede great
epidemics in human populations. Sylvatic plague, still another form, is carried by other rodents, e.g., squirrels, rabbits, chipmunks, in rural or wooded
areas where they are prevalent.

Bubonic plague, the most common form, is characterized by very high fever, chills, prostration, delirium, hemorrhaging of the small capillaries under
the skin, and enlarged, painful lymph nodes (buboes), which suppurate and may discharge. Invasion of the lungs by the organism (pneumonic plague)
may occur as a complication of the bubonic form or as a primary infection. Pneumonic plague is rapidly fatal and is the only type that can be spread
from person to person (by droplet spray) without intermediary transmission by flea. In the black form of plague, hemorrhages turn black, giving the
term "Black Death to the disease. An overwhelming infection of the blood may cause death in three or four days, even before other symptoms appear.

In untreated cases of bubonic plague the mortality rate is approximately 60%; pneumonic plague is usually fatal if not treated within 24 hours. Such
antibiotics as streptomycin and tetracycline greatly reduce the mortality rate. Vaccine is available for preventive purposes. Rodent control is
important in areas of known infection.

The earliest known visitation of the plague to Europe occurred in Athens in 430 B.C. A disastrous epidemic occurred in the Mediterranean during the
time of the Roman emperor Justinian; an estimated 25% to 50% of the population is reported to have succumbed. The most widespread epidemic
began in Constantinople in 1334, spread throughout Europe (returning Crusaders were a factor), and in less than 20 years is estimated to have killed
three quarters of the population of Europe and Asia. The great plague of London in 1665 is recorded in many works of literature. Quarantine measures
helped contain the disease, but serious epidemics continued to occur even in the 19th cent. The disease is still prevalent in parts of Asia. In Surat,
India, in 1994, 5,000 cases of pneumonic plague were reported in an outbreak; an estimated 100 people died, and over 400,000 people fled the city.
Because the number of cases of plague has been increasing annually, it is categorized as a re-emerging infectious disease by the World Health
Organization.

Characteristics:
1. also known as bubonic plague, black plague, plague
2. most deadly disease during the 1300s
3. source of infection is Yersinia pestis
4. spread via fleas, rats, humans, other organisms that carry Yersinia pestis

5. example of transmission of Yersinia pestis: It usually begins with the rat who carries the Yersinia pestis. If a flea begins feeding on the
infected rat's blood, the Yersinia pestis will multiply inside the flea's body. The Yersinia pestis clogs the flea's insides. The flea can prey on another
organism [such as man] and bite them. The flea essentially regurgitates its contaminated blood onto its victim, where the Yersinia pestis will enter the
new host's body through an opening, such as through the mouth or an exposed wound. If an infected person acquires pneumonia, he/she can transmit
the plague to another person by coughing or sneezing.

6. factors that contributed to spread of disease: rising population, strained resources, environmental change
7. no clear accounts on exactly how many died [much conflicting data]
8. estimated that one half of Europe, North Africa, and parts of Asia's populations were lost, class, race, or age does not matter
9. disease affected all its victims equally
10. in previous centuries, physicians and assistants were baffled by the plague and at loss to find a cure or way to halt spread of plague
11. no sooner had they begun working and aiding victims were they also infected with the disease

12. worst death toll in Europe's history occurred between 1347 and 1352 - approximately one fourth of Europe's population or 25 million people had
died from black death in only those five years

13. scapegoats included earthquakes, comets, lepers, Jews

Symptoms include, but not limited to:
main symptom caused by the lymph gland [buboes] - where term Bubonic is so called, appeared all over the body [especially in the groin, neck, and
armpits], would swell to the size of baseballs, red spots would form on skin, when spots turned black or purple, death was inevitable, muscular pains,
chills, headaches, seizures, fevers

Detection:
lab tests including blood culture, lymph node culture

Complications:
skin or physical damage, blood poisoning [septicemia]

Treatments:
1. previous treatments included subjecting victim to purging, bleeding, fumigating, bathing in urine, quarantine
2. modern treatments involve antibiotics, intravenous fluids, respiratory support
3. mortality rate is high, half of those infected will die if not treated

Protection:
1. thought to have eventually disappeared in the 1700s

2. pandemic in 1894 started in China, and infected Africa, the Pacific Islands, Australia, and the Americas through sea trades routes such as the Suez Canal

3. still occurs in Africa, South America, Australia, and Asia [not absolute]
4. has rarely attacked the United States since due to stricter checks and sanitation standards
5. vaccinations available, but not recommended because immunity is not guaranteed
6. overall, spread of black death has lessened due to the preventive measures of sanitation, rat killings, monitored transport of rats via ships

Superstitions
GOD'S PUNISHMENT: The most common belief was that the plague had been sent by God and that it was his punishment for the sins humankind had
committed. Even innocent people, such as infants, had to suffer for the horrible crimes of others. The church was quick to condemn gambling,
excessive drinking, the immodesty of women and the laziness of peasants. Guilt lay upon every man's heart. Therefore it was only natural that the first
measures taken against the plague were the confession of all sins and prayer for forgiveness.

FLAGELLATION: Confession and prayer, however, seemed to have very little effect. Therefore, many believed, there was a necessity for extreme
measures A group of men decided to punish themselves in order to persuade God to forgive them. Each of these "flagellants" would carry a scourge, a
wooden stick with a couple of leather tongs attached to one end. At the end of each tongs would be a sharp iron spike. about an inch in length.
The flagellants would walk from town to town in long processions. Once they arrive in a village, town or city, they would proceed to a public place, such
as a market place. Then they would begin to beat themselves which their scourges, hitting their backs until the blood flowed freely. Since they were
always welcome by the townspeople, they encouraged them to join the self-beatings. It was common for people to suddenly die in this ceremony. After
a few days, the flagellants would leave the town, usually in company of a few locals they had convinced to join. In this manner, their numbers steadily
grew to 200 to 300, and sometimes even 1000 per procession. Undoubtedly, the harm they inflicted on themselves did not help, but instead they
carried the plague with them where ever they went, only speeding up the process.

PROSECUTION OF JEWS: In Switzerland, it was a common belief that the Jews were poisoning the waters supplies. In some towns, all the Jews were
rounded up and burned to death. Those Jewswho had been lucky enough to be spared by the plague, found their death.

THE PLAGUE MAIDEN: Many commoners believed in a legendary witch called the plague maiden. She was supposedly very beautiful and carried
around a red scarf. It was said that she travelled from village to village, passing by each house. When she waved her red scarf in front of a house's
window or door, this house would become plague-infested. A legend told that a brave young man waited all night for the witch to arrive, and when she
did he cut her hand off with a sword. It was said that he was the last to die of the plague in his village.