What was the Bubonic Plague?

An epidemic of bubonic plague swept through Europe in the middle of the fourteenth century and killed every person in some villages and up to one third of the population of some countries. It took almost a century for Europe to recover economically and socially from the aptly named black death. The epidemic began in the far east of Asia, and plague is still present in many third-world Asian and African countries.

A bacterium called Yersinia pestis is responsible for bubonic plague. It normally infects rats, and passes from one rat to another in fleas. If a flea carrying the bacteria bites a human, that person will develop the disease. The infected patient will develop large, pus-filled glands (buboes) in the neck, groin and armpit. This is accompanied by a high fever, severe muscle pain, headache, rapid heart rate, profound tiredness and a coma. The infection may spread to the blood and cause black spots (bruises... thus the 'black death') under the skin. A plague pneumonia or meningitis may develop, and almost invariably these complications are fatal without excellent medical care. The diagnosis can be confirmed by special blood tests and cultures from the discharging glands.

Treatment involves isolation in hospital, antibiotics and intravenous drip feeding.

In good hospitals, virtually all patients will recover, but untreated the mortality rate can exceed 50%, and death may occur within a few hours of onset in those who are already malnourished or in poor health.

A plague vaccine is available to give partial protection to travelers and residents in areas where the disease is endemic. Tetracycline tablets can be taken on a daily basis to give good protection against the infection.

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