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TYPE OF DISEASE : BLACK DEATH
1. INTRODUCTION AND HISTORY OF BLACK DEATH
The Black Death arrived in Europe by sea in October 1347 when 12 Genoese tradin
ships docked at the !icilian port o" #essina a"ter a lon $ourney throuh the Black !ea%
The people who athered on the docks to reet the ships were &et with a horri"yin
surprise% #ost o" the sailors aboard the ships were dead' and those who were still alive
were ravely ill% They were overco&e with "ever' unable to keep "ood down and delirious
"ro& pain% !tranest o" all' they were covered in &ysterious black boils that oo(ed blood
and pus and ave their illness its na&e) the “Black Death%” The !icilian authorities
hastily ordered the "leet o"“
death ships”
out o" the harbor' but it was too late% Over thene*t "ive years' the &ysterious Black Death would kill &ore than 2+ &illion people in
Europe–al&ost one,third o" the continent’s population%
Even be"ore the “death ships” pulled into port at #essina' &any Europeans had
heard ru&ors about a “Great -estilence” that was carvin a deadly path across the
trade routes o" the .ear and /ar East% 0Early in the 134+s' the disease had struck hina'
ndia' -ersia' !yria and Eypt% owever' they were scarcely e5uipped "or the horrible
reality o" the Black Death% “ In men and women alike'” the talian poet Giovanni
Boccaccio wrote' “at the beginning of the malady, certain swellings, either on the groin
or under the armpits… waxed to the bigness of a common apple, others to the size of an
egg, some more and some less, and these the vulgar named plague-boils.” Blood and
pus seeped out o" these strane swellins' which were "ollowed by a host o" other
unpleasant sy&pto&s–"ever' chills' vo&itin' diarrhea' terrible aches and pains–and
then' in short order' death% The Black Death was terri"yinly' indiscri&inately contaious)
“the mere touching of the clothes'” wrote Boccaccio' “appeared to itself to
communicate the malady to the toucher %” The disease was also terri"yinly e""icient%
-eople who were per"ectly healthy when they went to bed at niht could be dead by
&ornin%
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Today' scientists understand that the Black Death' now known as the plaue' is
spread by a bacillus called 6ersina pestis% 0The /rench bioloist le*andre 6ersin
discovered this er& at the end o" the 18th century% They know that the bacillus travels
"ro& person to person pneu&onically' or throuh the air' as well as throuh the bite o"
in"ected "leas and rats% Both o" these pests could be "ound al&ost everywhere in &edieval
Europe' but they were particularly at ho&e aboard ships o" all kinds–which is how the
deadly plaue &ade its way throuh one European port city a"ter another% .ot lon a"ter
it struck #essina' the Black Death spread to the port o" #arseilles in /rance and the port
o" Tunis in .orth "rica% Then it reached 9o&e and /lorence' two cities at the center o"
an elaborate web o" trade routes% By the &iddle o" 134:' the Black Death had struck
-aris' Bordeau*' ;yon and ;ondon%
Today' this ri& se5uence o" events is terri"yin but co&prehensible% n the &iddle o"
the 14th century' however' there see&ed to be no rational e*planation "or it% .o one knew
e*actly how the Black Death was trans&itted "ro& one patient to another –accordin to
one doctor' "or e*a&ple' “instantaneous death occurs when the aerial spirit escaping
from the eyes of the sick man strikes the healthy person standing near and looking at the
sick ”–and no one knew how to prevent or treat it% -hysicians relied on crude and
unsophisticated techni5ues such as bloodlettin and boil,lancin 0practices that were
danerous as well as unsanitary and superstitious practices such as burnin aro&atic
herbs and bathin in rosewater or vinear%
#eanwhile' in a panic' healthy people did all they could to avoid the sick% Doctors
re"used to see patients< priests re"used to ad&inister last rites% !hopkeepers closed stores%
#any people "led the cities "or the countryside' but even there they could not escape the
disease) t a""ected cows' sheep' oats' pis and chickens as well as people% n "act' so
&any sheep died that one o" the conse5uences o" the Black Death was a European wool
shortae% nd &any people' desperate to save the&selves' even abandoned their sick and
dyin loved ones% “Thus doing '” Boccaccio wrote' “each thought to secure immunity
for himself %”
2. CURRENT STATUS OF THE DISEASE
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n 2+1=' the disease were reported in #ichian' >!% The #ichian Depart&ent o"
ealth and u&an !ervices announced that a in that state had the bubonic plaue' one o"
what is now 14 such cases reported nationwide in 2+1=% The a""ected resident is "ro&
#ar5uette ounty' which is in northern #ichian alon ;ake !uperior% But the resident
didn?t necessarily contract the disease in #ichian% The state aency noted he or she
@recently returned from Colorado in an area with reported plague activity”% olorado
has been hit hardest by the plaue this year% teenaer in ;ari&er ounty and an adult in
-ueblo ounty died "ro& the disease% The current annual >%!% tally is double the recent
averae 0althouh not yet a record%
Between 187+ and 2+12' the &a$ority o" hu&an plaue cases have been in .ew
#e*ico' ri(ona and olorado' the enters "or Disease ontrol 0D and -revention
reports% There have been other cases' but they have been in nearby Aestern and
!outhwestern states% There was one e*ception' in llinois% But as the D notes on a &ap
showin all the reports' @the case ... in Illinois was lab-associated '@ &eanin it arose out
o" a laboratory' rather than hu&an,to,hu&an or so&e other natural trans&ission%
Plague still around, but no longer a death sentence. While
the plague is often associated with the Middle Ages, when the
Blac !eath too "illions# li$es, it has ne$er co"pletel% goneawa%. &hat#s true e$en in highl% de$eloped countries. &he 'nited
(tates, for instance, has seen an a$erage of se$en such cases
annuall% in recent decades, according to the )!). About *+ of
those in$ol$e the bubonic plague.
The ood news is that' "or &ost people' the plaue isn?t the death sentence "or &ost
everyone that it was centuries ao' especially i" it?s detected early% t can be treated with
&odern &edicine such as antibiotics and anti&icrobial%
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-laue cases in the >nited !tates' 187+–2+12% !ince the &id–2+th century' plaue
in the >nited !tates has typically occurred in the rural Aest% The case shown in llinois
was lab,associated%
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3. RESEARCH AND CASE STUDIES OF THE BLACK DEATH
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4. SYMPTOMS OF THE BLACK DEATH DISEASE
The Black Death is a serious bacterial in"ection that can be deadly% !o&eti&es
re"erred to as the @plaue'@ the disease is caused by bacterial strain called 6ersinia
pestis. This bacteria is "ound on ani&als throuhout the world and is usually trans&ittedto hu&ans throuh "leas% The risk o" plaue is hihest in areas that have poor sanitation'
overcrowdin' and a lare population o" rodents% n &edieval ti&es' the plaue' or @black
death'@ was responsible "or the deaths o" &illions o" people in Europe% Today' there are
only 1'+++ to 2'+++ cases reported worldwide each year' with the hihest incidence in
"rica%
i% Types o" Black Death
• Bubonic -laue
The &ost co&&on "or& o" plaue is bubonic plaue% t’s usually contracted when
an in"ected rodent or "lea bites you% n very rare cases' you can et the bacteria "ro&
&aterial that has co&e into contact with an in"ected person% Bubonic plaue in"ects
your ly&phatic syste& 0the i&&une syste&' causin in"la&&ation% >ntreated' it
can &ove into the blood and cause septice&ic plaue' or to the luns' causin
pneu&onic plaue%
• !eptice&ic -laue
Ahen the bacteria enter the bloodstrea& directly and &ultiply there' it’s known as
septice&ic plaue% Ahen they’re le"t untreated' both bubonic and pneu&onic
plaue can lead to septice&ic plaue%
• -neu&onic -laue
Ahen the bacteria spread to the luns' you have pneu&onic plaue - the &ost
lethal "or& o" the disease% Ahen so&eone with pneu&onic plaue couhs' the
bacteria "ro& their luns are e*pelled into the air% Other people who breathe that air
can also develop this hihly contaious "or& o" plaue' which can lead to
an epide&ic% -neu&onic plaue is the only "or& o" the plaue that can be
trans&itted "ro& person to person%
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ii% !in and sy&pto&s o" Black Death
-eople in"ected with the plaue will usually develop "lu,like sy&pto&s two to si* days
a"ter in"ection% There are other sy&pto&s that can distinuish between the three "or&s o"
the plaue)
• Bubonic -laue !y&pto&s
Generally appear within two to si* days% They include' ever and chills' headache'
&uscle pain' eneral weakness' and sei(ures% 6ou &ay also e*perience pain"ul'
swollen ly&ph lands' called buboes% These typically appear in the roin' ar&pits'
neck' or site o" the insect bite or scratch% The buboes are what ive bubonic plaue
its na&e%
•-neu&onic -laue !y&pto&s
#ay appear as 5uickly as one day a"ter e*posure to the bacteria% These sy&pto&s
include trouble breathin' chest pain' couh' "ever' headache' overall weakness' and
bloody sputu& 0saliva and &ucus or pus "ro& the luns
• !eptice&ic -laue !y&pto&s
>sually start within two to seven days a"ter e*posure' but septice&ic plaue can lead
to death be"ore sy&pto&s even appear% !y&pto&s can include abdo&inal pain'
diarrhea' nausea and vo&itin' "ever and chills' e*tre&e weakness' bleedin 0blood
&ay not be able to clot' shock' and skin turnin black 0anrene%
5. CAUSES OF THE BLACK DEATH
Ahat caused the Black Death' the terrible plaue that &ay have killed as &any as
hal" o" all Europeans in the 14th century t has been assu&ed by &ost people' that it was
caused by the bacteriu& 6ersinia pestis ' the causative "actor o" bubonic plaue% This
"ascinatin and provocative book called' “ iology of !lagues " #vidence from
$istorical !opulations”' however' suests otherwise%
Bubonic plaue is a disease o" rodents that lurks in isolated parts o" central sia and
northern "rica% t has recently beco&e established in wild rodent populations o" .orth
&erica% s recently as the early 2+th century' plaue broke out repeatedly "ro& these
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re"ues into the hu&an populations o" southern sia and ndia% Be"ore the availability o"
antibiotics' it caused &illions o" deaths%
The bubonic "or& o" plaue' &arked by the rossly swollen ly&ph nodes in the roin
and neck known as buboes' is spread by rat "leas% Ahen the uts o" the "leas are blocked by bacterial rowth' they will bite hu&ans% n the pneu&onic "or&' the luns
hae&orrhae and the patient breathes out clouds o" bacteria' spreadin the plaue directly
"ro& one hu&an to another%
ll this has been well established throuh the investiations o" &odern &edicine%
Ahat is not well established is the nature o" the plaues o" earlier centuries% !o&e o"
these had the typical sy&pto&s o" bubonic plaue' and so&e did not% The Black Death is
particularly pu((lin' "or it spread in a pattern very unlike that o" present,day bubonic
plaue% .otably' it spread to new reions even in winter% This is strane' "or in the #iddle
es the only rats that we have evidence o" in Europe were tropical black rats% n winter'
these rats &ust have huddled in the war&th o" houses' seldo& travellin%
These discrepancies have led a nu&ber o" authors to suest that the plaue was
indeed bubonic but that it spread pri&arily in the pneu&onic "or&% But death "ro& this
"or& is so swi"t that it is hard to see how it could have been trans&itted over substantial
distances% Others have suested that the Black Death was caused by so&e other aent'
thouh they tend to be vaue about what that &iht have been%
The authors o" the book “ iology of !lagues " #vidence from $istorical
!opulations”' !usan !cott and hristopher Duncan' o even "urther% They suest that
e*cept "or isolated outbreaks near the #editerranean' "ew i" any o" the plaue outbreaks
o" Europe were bubonic or pneu&onic% They &arshal a reat deal o" epide&ioloical
evidence supportin their view that the bi plaues' "ro& that o" Custinian in the th
century to the reat plaue o" ;ondon in 1=' were caused by soðin else%
-erhaps' they suest' these plaues were hae&orrhaic "evers caused by viruses'
possibly "iloviruses allied to #arbur or Ebola , but they are care"ul to point out that the
viruses were unlikely to have been either o" these% #arbur and Ebola have relatively
short incubation ti&es and are rarely trans&itted "ro& one hu&an to another% .either do
these viruses produce the buboes that "iure so stronly in &any &edieval descriptions o"
plaues% Buboes are characteristic o" severe bacterial in"ections' the result o"
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enore&ent o" the ly&ph nodes with bacteria killed by the i&&une syste& and with
phaocytes that are "rantically tryin to enul" the& all% They are not "ound in viral
diseases% !uch diseases tend to produce &uch s&aller swellins o" the ly&ph nodes' a
point that the authors nelect to &ention%
Do the authors &ake their case do not think so' thouh they raise &any
challenin issues% Bubonic plaue was certainly not the only disease to devastate Europe
in those hastly centuries% !o&e' such as the sweatin sickness that swept throuh
Enland at the end o" the 1=th century' were see&inly di""erent "ro& any present,day
diseases% But the buboes' and the occasional accounts o" &assive die,o""s o" ani&als'
suest that bubonic and perhaps pneu&onic plaue were widespread% There is also
tantalisin evidence "ro& &olecular bioloy% Traces o" the D. o" 6ersinia pestis have
been "ound in hu&an re&ains "ro& 14th,century -rovence and "ro& the 1:th,centuryoutbreak in #arseilles% owever' there is no evidence as yet o" the presence 0or absence
o" this bacteriu& "ro& &edieval ce&eteries "arther "ro& the #editerranean%
ow the Black Death !pread
• Bubonic lague was spread b% the fleas who li$ed on plague
infected rats, and such rats were ubi/uitous on trading
ships.
•
neu"onic lague could spread with a snee0e and 1u"p fro"person to person with terrif%ing speed.
• (eptice"ic lague spread through contact with open sores.
Throuh these ðods o" contaion' the Black Death spread via trade routes "ro&
sia to taly' and thence throuhout Europe%
What Medie$al People Belie$ed )aused the Plague
The &ost co&&on assu&ption was that God was punishin &ankind "or its sins%
There were also those who believed in de&onic dos' and in !candinavia' the superstition
o" the -est #aiden was popular% !o&e people accused the Cews o" poisonin wells< the
result was a horri"ic persecution o" Cews that the papacy was hard,put to stop% !cholars
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atte&pted a &ore scienti"ic view' but they were ha&pered by the "act that the &icroscope
wouldn?t be invented "or several centuries% The >niversity o" -aris conducted a study' the
-aris onsiliu&' which' a"ter serious investiation' ascribed the plaue to a co&bination
o" earth5uakes and astroloical "orces%
2ow People 3eacted to the Blac !eath
/ear and hysteria were the &ost co&&on reactions% -eople "led the cities in panic'
abandonin their "a&ilies% .oble acts by doctors and priests were overshadowed by those
who re"used to treat their patients or ive last rites to plaue victi&s% onvinced the end
was near' so&e sank into wild debauchery< others prayed "or salvation% /laellants went
"ro& one town to another' paradin throuh the streets and whippin the&selves to
de&onstrate their penitence%
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6. CONCLUSION
Even thouh the black death once were a deadly epide&ic that responsible "or the
death o" &illions o" people in Europe' nowadays' the black death also known as plaue
can be prevent% Today the risk o" developin plaue is 5uite low' with only 1'+++ to 2'+++
cases reported to the Aorld ealth Orani(ation 0AO each year% n 2+13' there were
only 7:3 cases reported worldwide' with 12 deaths% Outbreaks are enerally associated
with in"ested rats and "leas in the ho&e% rowded livin conditions and bad sanitation
also increase the risk o" plaue%
Today' &ost hu&an cases o" the plaue occur in "rica% The countries in which the
plaue is &ost co&&on are #adaascar' the De&ocratic 9epublic o" ono' and -eru%
The plaue is rare in the >nited !tates' but the disease is still so&eti&es "ound in the
rural southwest' and in particular ri(ona' olorado' and .ew #e*ico% The last epide&ic
o" plaue in the >nited !tates occurred in 1824 to 182=' in ;os neles% There are an
averae o" seven cases reported each year in the >nited !tates' &ost o" which have been
in the "or& o" the bubonic plaue% There has not been a case o" person,to,person
trans&ission o" the plaue in the >nited !tates since 1824%
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7. REFERENCES
• The Black Death' 134,13=3% The Complete $istory 0Boydell Brewer' 2++4
• !usan !cott hristopher C% Duncan% iology of !lagues" #vidence from
$istorical !opulations. 0a&bride >niversity -ress' 2++1
• #%A% Dols'The lack %eath in the &iddle #ast. 0-rinceton' 187+
• C% atcher% !lague, !opulation and the #nglish #conomy '()*-
'+( 0Basinstoke' 1877
• C% atcher% #ngland in the ftermath of the lack %eath. 0-ast -resent' 1884
• ;%/% irst% The Conuest of !lague. 0O*"ord' 18=3
• .. .ews by Gre Botelho% ubonic plague reported in &ichigan. 0!epte&ber
1=' 2+1=• Twi' G%' 018:4' The lack %eath" iological /eappraisal ' ;ondon) Bats"ord%
• !hrewsbury' C% /% D%' 0187+' $istory of ubonic !lague in the ritish Isles'
;ondon) a&bride >niversity -ress%
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