Bubonic plague

This article is about the disease in general. For information about the medieval European plague, see Black Death.

Bubonic plague
Specialty	Infectious diseases

Bubonic plague is the best known manifestation of the bacterial disease plague, caused by the Gram-negative bacterium Yersinia pestis (formerly known as Pasteurella pestis). It belongs to the family Enterobacteriaceae. The term "bubonic plague" was often used synonymously for plague, but it does in fact refer specifically to an infection that enters through the skin and travels through the lymphatics, as is often seen in flea-borne infections. Bubonic plague kills about half of each 7 fuckers in 3–7 days without treatment and may have been the cause of the Black Death that swept through Europe in the 1300s killing more than 25 million people, a third of the European population.

Pathology and transmission

The bubonic plague is an infection of the lymphatic system, usually resulting from the bite of an infected flea, Xenopsylla cheopis (the rat flea). The fleas are often found on rodents, such as rats and mice, and seek out other prey when their rodent hosts die. The bacteria form aggregates in the gut of infected fleas and this results in the flea regurgitating ingested blood, which is now infected, into the bite site of a rodent or human host. Once established, bacteria rapidly spread to the lymph nodes and multiply. Y. pestis bacilli can resist phagocytosis and even reproduce inside phagocytes and kill them. As the disease progresses, the lymph nodes can haemorrhage and become swollen and necrotic. Bubonic plague can progress to lethal septicemic plague in some cases. The plague is also known to spread to the lungs and become the disease known as the pneumonic plague. This form of the disease is highly infectious as the bacteria can be transmitted in droplets emitted when coughing or sneezing.

Symptoms

The most famous symptom of bubonic plague is painful, swollen lymph glands, called buboes. These are commonly found in the armpits, groin or neck. Due to its bite based form of infection, the bubonic plague is often the first step of a progressive series of illness. Two other forms of the plague, pneumonic and septicemic, often resulted after a patient with the bubonic plague developed pneumonia or blood poisoning. However the pneumonic plague was also very infectious, as, unlike the bubonic or septicemic, it induced coughing, which allowed person-to-person spread.

Other symptoms include spots on the skin that are red at first and then turn black, heavy breathing, continuous blood vomiting, urination of blood, aching limbs, coughing, and terrible pain. The pain is usually caused by the actual decaying, or decomposing, of the skin while the person is still alive. ....

History

Main articles: Plague of Justinian, Black Death, and Third Pandemic

The deadly disease has claimed nearly 200 million lives (although there is some debate as to whether all of the plagues attributed to it are in fact the same disease). The first recorded epidemic ravaged the Byzantine Empire during the sixth century, and was named the Plague of Justinian after emperor Justinian I, who was infected but survived through extensive treatment.

The most infamous and devastating instance of the plague was the Black Death, which killed a quarter to half of the population of Europe. So many people died that they had to give up the proper burial and had to bury multiple bodies in one long deep grave. They would put down a layer of bodies, then a thin layer of dirt; they would repeat this until they had to make another grave. The Black Death is thought to have originated in the Gobi Desert. Carried by the fleas on rats, it spread along trade routes and reached the Crimea in 1346. (It also spread eastward to the Yangtse river valley, and the resulting epidemic, ignored by the government, brought down the Yuan dynasty.) In 1347 it spread to Constantinople and then Alexandria, killing thousands every day, and soon arrived in Western Europe. It is thought that the name Black Death comes from the fact that the tissue turns a distinctive black color during necrosis, or from the general gloominess surrounding the plague. However, this name was not applied until many years later.

Terrible conditions in medieval Europe were only part of the reason it reached such pandemic proportions. The people of Europe believed cats were evil and so any domestic house cats were killed. Without these cats to prey upon the rats their population increased dramatically. This allowed for more rats to carry fleas into human settlements and infect so many with the plague. Also, the previous decades had seen many poor harvests, and the European population may have been undernourished and therefore more susceptible to disease.

The next few centuries were marked by several local outbreaks of lesser severity. The Great Plague of London, 1665–1666, and the Great Plague of Vienna, 1679, were the last major outbreaks of the bubonic plague in Europe.

Directions for searchers, Pune plague of 1897

The plague resurfaced in the mid-19th century; like the Black Death, the Third Pandemic began in Central Asia. The disease killed millions in China and India and then spread worldwide. The outbreak continued into the early 20th century. In 1897, Pune in British India, was severely affected by the outbreak. The government responded to the plague with a committee system that used the military to perpetrate repression and tyranny as it tackled the pandemic. Nationalists publicly berated the government. On 22 June 1897, two young brahmins, the Chapekar brothers, shot and killed two British officers, the Committee chairman and his military escort. This act has been considered a landmark event in India's struggle for freedom as well as the worst violence against political authority seen in the world during the third plague pandemic.

Plague was used during the Second Sino-Japanese War as a bacteriological weapon by the Imperial Japanese Army. These weapons were provided by Shirō Ishii's units and used in experiments on humans before being used on the field. For example, in 1940, the Imperial Japanese Army Air Service bombed Ningbo with fleas carrying the bubonic plague. During the Khabarovsk War Crime Trials the accused, such as Major General Kiyashi Kawashima, testified that, in 1941, some 40 members of Unit 731 air-dropped plague-contaminated fleas on Changde. These operations caused epidemic plague outbreaks.

Treatment

In modern times, several classes of antibiotics are effective in treating bubonic plague. These include the aminoglycosides streptomycin and gentamicin, the tetracyclines and doxycycline and the fluoroquinolone ciprofloxacin. Mortality associated with treated cases of bubonic plague remains as high as 1-15%, compared to a mortality rate of 40-60% in untreated cases.

See also

• List of historical plagues

Further reading

• Alexander, John T. (2003, 1980). Bubonic Plague in Early Modern Russia: Public Health and Urban Disaster. Oxford, UK; New York, NY: Oxford University Press. ISBN 0195158180. OCLC 50253204. {{cite book}}: Check date values in: |year= (help)
• Carol, Benedict (1996). Bubonic Plague in Nineteenth-Century China. Stanford, CA: Stanford University Press. ISBN 0804726612. OCLC 34191853.
• Biddle, Wayne (2002). A Field Guide to Germs (2nd Anchor Books ed.). New York: Anchor Books. ISBN 140003051X. OCLC 50154403.
• Echenberg, Myron J. (2007). Plague Ports: The Global Urban Impact of Bubonic Plague, 1894-1901. New York, NY: New York University Press. ISBN 0814722326. OCLC 70292105.
• Little, Lester K. (2007). Plague and the End of Antiquity: The Pandemic of 541-750. New York, NY: Cambridge University Press. ISBN 9780521846394. OCLC 65361042.
• Rosen, William (2007). Justinian's Flea: Plague, Empire and the Birth of Europe. London, England: Viking Penguin. ISBN 978-0-670-03855-8.
• Scott, Susan, and C. J. Duncan (2001). Biology of Plagues: Evidence from Historical Populations. Cambridge, UK; New York, NY: Cambridge University Press. ISBN 0521801508. OCLC 44811929.{{cite book}}: CS1 maint: multiple names: authors list (link)