The Middle Ages
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
If Yersinia pestis, the plague bacillus, enters the body via the bite of an infected flea, the disease follows the pattern known as bubonic plague. After an incubation period that may last for 2–6 days, victims suddenly experience fever, headache, chest pain, coughing, difficulty in breathing, vomiting of blood, and dark blotches on the skin. The painful swellings called buboes that appear in the lymph nodes (usually in the groin, armpits, and neck) are the most characteristic signs of plague. Other symptoms include restlessness, anxiety, mental confusion, hallucinations, and coma. In septicemic plague, the bacteria spread rapidly throughout the bloodstream, damaging internal organs and blood vessels, leading to gangrene, internal hemorrhaging, delirium, or coma. Death occurs within 1–3 days, without the appearance of buboes.
Chemical and Biological Threats to Public Safety
Frank A. Barile in Barile’s Clinical Toxicology, 2019
Plague is an infectious disease of animals and humans caused by the bacterium Yersinia pestis. All yersinia infections are zoonotic, capable of spreading from rodents and their fleas (urban plague) as well as from squirrels, rabbits, field rats, and cats (sylvatic plague). Historically, pandemics resulting from yersinia infections have devastated human populations. The first of three urban plagues started in Egypt (541 AD) and spread through the Middle East, North Africa, Asia, and Europe, killing over 100 million persons. The Middle Ages (1340s) recorded a second pandemic that probably originated from Asia and spread through Europe, resulting in 25 million deaths in Europe. Recent history (1895) recorded a pandemic that began in Hong Kong and spread to Africa, India, Europe, and the Americas, leaving 10 million deaths in its wake over 20 years. The recognition of public health and maintenance of hygienic standards has essentially eradicated urban plague from most communities, although some cases are reported in the United States annually. Clinically, Y. pestis infections are manifested as bubonic plague and pneumonic plague.
Global health
Kevin McCracken, David R. Phillips in Global Health, 2017
Military and trading contacts between Eurasian civilizations were the source of many historic disease transfers/exchanges. The most devastating such outbreak was the mid-fourteenth-century Black Death (bubonic plague) pandemic which is estimated to have killed between a quarter and a third of the total population of Europe. This catastrophic outbreak is believed to have originated in China in the 1330s, moved along the Silk Road and other trade routes to reach Constantinople (today's Istanbul) in 1347 and then advancing through Western and Northern Europe over the next three years. The plague also spread widely in China, causing millions of deaths. The Middle East was affected, too. The massive death toll shook all aspects of life in Europe – society, economy, politics and religion – with many present-day historians tracing the end of feudalism, the roots of capitalism and the impetus for the Protestant Reformation of the sixteenth century to the Black Death. In turn, in Asia the Black Death severely weakened the powerful Mongol Empire through population loss and the decline of trade, a development which was to help the subsequent rise of Western Europe as a world power.
War on Rats: the architecture of the bubonic plague in Galveston
Published in Baylor University Medical Center Proceedings, 2023
Leonard Kuan-Pei Wang
The accessibility of Galveston, while contributing to its strong cotton export industry and economic growth, also made it vulnerable to communicable diseases. Indeed, the bubonic plague bacterium, Yersinia pestis, likely spread to Galveston via infected rats and fleas on steamboats. The Galveston outbreak was not unique, as several bubonic plague outbreaks—suspected to be from the same source—occurred in other Gulf Coast ports in the 1920s.2 In fact, during the first quarter of the 20th century, 496 human plague cases were reported in the United States, with 344 reported as bubonic plague.3Y. pestis spread to multiple port cities, mainly along the California and Louisiana coasts.4 However, it appears that Y. pestis was only able to establish successfully in port cities along the Pacific Ocean. Among Gulf Coast ports, Y. pestis appears to have never spread beyond rodent populations within the cities—a phenomenon attributed to unfavorable environmental conditions as well as effective public health responses.3 As examined in this essay, one such public health response—the “War on Rats” in Galveston during the 1920s—left lasting impacts on the city’s history and architecture.
Facts and ideas from anywhere
Published in Baylor University Medical Center Proceedings, 2019
William C. Roberts
On May 27, 1907, 13 months after the earthquake, a new case of bubonic plague appeared, and in a span of less than a week, six other victims were diagnosed in the city. Chinatown, the center of the first outbreak, seemed to be the only neighborhood spared. By this time, Blue had returned to Norfolk, Virginia. Unable to focus their attention on a single neighborhood, health officials felt pulled in every direction, not knowing where the next victim might emerge. There was no neighborhood to quarantine, no community to target, and little hope of walling off the disease. For the first time since the plague had appeared in the city 7 years earlier, it felt like all of San Francisco was at risk. All of the recent victims were white, proving that the plague was not restricted along racial lines.
The internet era for pandemics
Published in Pathogens and Global Health, 2021
Christos Louis
Historical killer epidemics continued in later centuries, including the major pandemic outbreaks of bubonic plague in the Middle Age and later. It is accepted that only three of these resulted, collectively, in the loss of more than 250 million people worldwide. Thereafter, in addition to several regional epidemics caused by different pathogens, the world has seen the post-Colombian import of European diseases into the Americas, and of syphilis to Europe (although the latter is nowadays doubted by some). The most recent major pandemics were the Spanish flu at the end of WW1 and, jumping into the present modern world, the emergence and spread of AIDS, which has already cost the loss of up to 45 million lives.
Related Knowledge Centers
- Bacteria
- Fever
- Plague
- Vomiting
- Yersinia Pestis
- Bubo
- Lymphadenopathy
- Headache
- Influenza-Like Illness
- Acral Necrosis
