The Descriptions and Effects of the Bubonic Plague, Septicemia and Pneumonia

The Plague is a word that has horrified many populations over the centuries across the globe. It remains a feared word today. This term describes a number of diseases; the three most common types are referred to as the Bubonic Plague, Septicemia, and Pneumonic. Plague pneumonia, or pneumonic plague, is caused by the same bacterium as bubonic plague but is acquired by inhaling infected droplets from the lungs of a person whose plague infection has spread to the respiratory system. This is the most contagious form of the disease and the type that progresses most rapidly, with death typically occurring in less than three days in virtually all untreated cases.

The bubonic plague is by far the most familiar form of the disease. Its initial appearance led to major changes in European society. It was nicknamed "The Black Death" due to the red-black spots it produced on the skin. This horrific killer hung over Europe, and medieval medicine had nothing to combat it.

The Bubonic plague is a severe infection that affects both humans and numerous species of rodents. It is caused by the Yersinia pestis bacterium, which is transmitted by fleas that have ingested blood from infected rodents, primarily rats. The ingested plague bacteria multiply in the flea's upper digestive tract and eventually block it. When the flea feeds again on a human or another rodent, this obstruction causes the newly ingested blood to regurgitate back into the bite, along with the plague bacteria. The victim's bloodstream then transports the bacteria throughout the body.

The first signs of illness in humans appear within about a week and are abrupt. Within a few hours, the body temperature rises to around 40 degrees C (104 degrees F), and the victim becomes gravely ill, experiencing vomiting, muscle pain, mental disorganization, and delirium. The bacteria invade the lymph nodes close to the bite, causing noticeable, painful swelling. Lymph nodes throughout the body, especially those in the groin and thighs, become enlarged. These swollen lymph nodes, called buboes (from where the disease gets its name), fill with pus, and the disease spreads via the infected bloodstream and lymphatic system. These symptoms quickly overwhelm the body's defenses, incapacitating its immune response. In 60-90 percent of untreated cases, death occurs within a few days. Over time, and with the progress of medical science, treatments have become more sophisticated. Today, early detection can be treated with antibiotics, and preventative vaccines are available. The first vaccine was developed by Russian scientist Waldemar Haffkine in 1895. A vaccine is available today, but its true preventative value is somewhat unclear.

This disease has a long history. The earliest accounts date back to 1000 BC. It re-emerged in 4th Century Constantinople (present-day Turkey). Regular outbreaks in the Mediterranean region are documented. The "Black Death" made its deadliest appearance in the 1300s. In the early 1330s, a lethal outbreak of bubonic plague occurred in China. Once infected, people rapidly spread the disease to others.

Since China was one of the busiest trading nations, it was only a matter of time before the outbreak of the plague spread to Western Asia and Europe. In October of 1347, several Italian merchant ships returned from a trip to the Black Sea, a crucial link in trade with China. When the ships docked in Sicily, many of those onboard were already dying of the plague. Within days, the disease spread to the city and the surrounding countryside. The disease is believed to have traveled from Central Asia, to the Mediterranean, and onward throughout the rest of Europe. As trade increased, so did the spread of the disease. This trail resulted in a decline of the European population by half. A third outbreak appeared in China in the 1800s, which reduced the local population by 20 million. Today, outbreaks of the plague have occurred in parts of Asia, Africa, and South America, with isolated cases occurring annually in the United States. Small epidemics of bubonic plague continue to occur in various areas of the world, including the USA. These epidemics fail to spread beyond local outbreaks, however, which may suggest that less virulent strains of the plague bacteria have evolved over the years, providing relative immunity to many individuals. The re-emergence of the plague underscores its presence as a chronic disease amongst wild rodents.

In winter, the disease seemed to disappear, only because the fleas (which were now helping to transmit it) are inactive during this season. Each spring, the plague returned, claiming new victims. After five years, 25 million people were dead, amounting to one-third of Europe's population. This disease had a significant impact on society in those early days, particularly affecting the social structure during the medieval era. The decline in the working-class population led to the ultimate downfall of the feudal system. With fewer workers and abandoned farms, commodities were in short supply. Medieval society never recovered from the impact of the plague. So many people had died that there were severe labor shortages all over Europe. This triggered workers to demand higher wages, but landlords refused these demands. By the end of the 1300s, peasant revolts broke out in England, France, Belgium, and Italy. Commercial activities came to a halt. Those unaffected took refuge in walled cities for protection. Educational resources were depleted, replaced with untrained individuals, leading to increased use of local languages.

The most effective way to prevent the plague is by reducing rodent and flea populations through proper hygiene and the use of rodenticides and insecticides. The plague organism responds to antibiotics like streptomycin, chloramphenicol, and tetracycline if treatment begins within approximately 15 hours of the first appearance of symptoms.

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