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Black Death

From Wikipedia, the free encyclopedia.

The Black Death (also The Plague, and latterly Black Plague though not called this in earlier times) was a devastating epidemic in Europe in the 14th century which is estimated to have killed about a third of the population. Most scientists believe that the Black Death was an outbreak of Bubonic Plague - (described below), a dreaded disease that has spread in pandemic form several times through history. The plague is caused by the bacterium Yersinia pestis which is spread by fleas with the help of animals like the black rat (Rattus rattus) -what we would call today the sewer rat. Sometimes, the term "Black Death" is used for all outbreaks of plague and epidemics.PlagueFlea.jpg
A DANGEROUS PLAGUE VECTOR — THE FLEA

Its Evolution

It is not entirely clear where the major epidemic of the 14th century started, but it was probably somewhere around the northern parts of India. For eons it lived in the blood of resistant wild rodents in northern Asia. It then spread west to the Middle East. The plague was imported to Europe by the way of the Crimea, where the Genoese colony Kaffa (Feodosiya) was besieged by the Mongols. History says that the Mongols catapulted infected corpses into the city. The refugees from Kaffa then took the plague along to Messina, Genoa and Venice, around the turn of 1347 - 1348 CE. Some ships didn't have anyone alive when they reached their port. From Italy the disease spread clockwise around Europe, hitting France, Spain, England (in June 1348) and Britain, Germany, Scandinavia and finally north-western Russia around 1351. During the Middle Ages, it somehow began to infect the domestic rats that infested towns and cities. After the rats died, their fleas fed upon the villagers themselves. Unable to imagine what was happening to them, more than half of Europe's entire population died as black death swept the continent.

History

The first recorded plague was told of in First Samuel in The Torah. It began about 1000 BCE. and was called the "Plague of Ashod." About 542 CE. the first pandemic plague occurred. It struck in Constantinople (Modern day's Istanbul) and killed about half the population. The Black Death was the second recorded pandemic. It began in central Asia and was carried west to Europe by trading ships.

The disease started on the shores of the Black Sea where sailors landed. Ships often unknowingly carried the rats on board, which hastened the spread of the disease to Italy and other countries. The large numbers of dead rats were noted in the areas of disease, but the connection wasn’t immediately noted. Many people believed it was a curse, or caused by earthquakes releasing fumes from the Earth’s core, or by climatic changes. In Venice, a declaration was made that no one could leave incoming ships for 40 days, to be sure they did not carry the disease to the city. This was called quaranta giorni, which came from the 40 days of Christ’s suffering in the wilderness and is where our word “quarantine” comes from. It was not effective--60,000 people in the city still died.

People's reaction to the illness varied. Some went into total isolation to try to avoid the disease, some took the philosophy “play today for tomorrow we die,” and totally ignored the disease, and some fled in an attempt to escape it. It lasted a little more than a year in Italy, and, although accurate records were not kept, deaths probably took between a third and half of the population.

Consequences

The information about the death toll varies widely from source to source, but it is estimated that about a third of the population of Europe died from the outbreak in the mid- 1300s. Approximately 25 million deaths occurred in Europe alone with many others occurring in Africa and Asia. Some villages were deserted with the few survivors fleeing and spreading the disease further.Doktorschnabel_430px.jpg
*“Doktor Schnabel von Rom”
("Doctor Beak from Rome")
engraving by Paul Fürst (after J Columbina)*
A doctor in an anti-plague suit

The great population loss brought economic changes based on increased social mobility as depopulation eroded peasant obligations (already weakened) to remain on their traditional holdings. The sudden scarcity of cheap labor provided an incentive for innovation that broke the stagnation of the Dark Ages and, some argue, caused the Renaissance, despite the Renaissance occurring in some areas (such as Italy) before others. Because of the depopulation, though, the surviving Europeans became the biggest consumers of meat for a civilization before industrial agriculture.

Another belief was that carrying sweet-smelling herbs and flowers and holding them to the nose helped to ward off poisonous vapor which helped start the popular legend that the Black Death inspired one of the most enduring nursery rhymes in the English language, Ring around a rosie, a pocket full of posies, / Ashes, ashes, we all fall down. (or a-tishoo, a-tishoo, we all fall down) turns out on closer examination to be false. However it did lead to the displacement of French with English.

Alternative explanations

Recently the scientists Susan Scott and Christopher Duncan from Liverpool University have proposed the theory that the Black Death might have been caused by an Ebola-like virus, not a bacterium. Their rationale is that this plague spread much faster and the incubation period was much shorter than the plagues caused by Yersinia pestis. It also took place in completely ratless areas like Iceland. It was transferred between humans (which happens rarely with Yersinia pestis), and some genes that determine immunity to Ebola-like viruses are much more widespread in Europe than in other parts of the world.

In a similar train of thought, historian Norman F. Cantor, in his 2001 book In the Wake of the Plague, suggests the Black Death might have been a combination of pandemics including a form of anthrax, a cattle murrain. Among the evidence he cites are reported disease symptoms not in keeping with the known effects of either bubonic or pneumonic plague; the discovery of anthrax spores in a plague pit in Scotland, and the fact that meat from infected cattle was known to have been sold in many rural English areas prior to the onset of the plague.

Moreover, what was previously considered to be final evidence for the Yersinia pestis theory, tooth pulp tissue taken from a 14th century plague cemetery in Montpellier containing Y. pestis DNA, was never confirmed in any other cemetery.

There are counter-arguments to this theory, however. Historical examples of pandemics of other diseases in populations not previously exposed, such as smallpox and tuberculosis amongst American Indians, show that because there is no inherited adaptation to the disease, its course in the first epidemic is faster and far more virulent than later epidemics amongst the descendants of survivors. The Middle East and Far East were affected equally badly (as the Rihla of Ibn Battuta testifies), so the prevalence of immunity genes specifically in Europeans is curious. Furthermore, the plague returned again and again and was recognised as the same disease through succeeding centuries into modern times when the Yersinia bacterium was identified.

In September 2003, a team of researchers from Oxford University revealed the surprising results of tests made on 121 teeth from 66 skeletons found in 14th century mass graves. The remains showed no genetic trace of Yersinia pestis, and the researchers suggest that the Montpellier study might have been flawed.

Bubonic plague

Bubonic plague is an infectious disease that is believed to have caused several epidemics or pandemics throughout history. The plague was caused by a complex series of bacterial strains called Yersinia pestis (Y. pestis), found in the digestive tract of fleas. There are 3 varieties of plague: bubonic, pneumonic and septicaemic. : 1. Bubonic- Swollen lymph nodes (called buboes) develop 1-8 days after exposure. Their appearance is associated with the onset of sudden fever, chills, and headache, which often are followed by nausea and vomiting several hours later. The buboes become visible within 24 hours and cause severe pain. Untreated, septicemia (blood poisoning) develops in 2-6 days. Up to 15% of bubonic plague victims develop secondary pneumonic plague and thus can spread illness from person to person by coughing. Most common form of plague. 2. Pneumonic -The bacteria is in the lungs. It is extremely dangerous since coughing can spread it. Pneumonic plague may occur primarily from inhaling organisms in the air or from exposure to infected blood. Victims typically have a productive cough with blood-tinged sputum within 24 hours of symptom onset. 3. Septicemic -The bacteria is in the bloodstream. Septicemia plague may occur with bubonic plague. The signs and symptoms of primary septicemic plague include fever, chills, nausea, vomiting, and diarrhea. Later, bleeding in the skin may develop, hands and feet may lose circulation, and tissue may die.

Bubonic is by far the most common. About six days after suffering the infected flea bite, the victim develops a blackish pustule at the point of the bite. This is followed by a swelling of the lymph nodes in the affected limb as the body tries to cope with the infection. These are the buboes, from which bubonic plague gets its name. Finally, subcutaneous haemorrhaging occurs, causing purplish blotches. The bacilli overwhelm the nervous system, causing neurological and psychological disorders which may go to explain the danse macabre rituals associated with the Black Death, and killing 50-60% of its victims.

Infection

Any serious outbreak of plague is started by other disease outbreaks in the rodent population. During these outbreaks, infected fleas that have lost their normal hosts seek other sources of blood. It usually lives in the fleas of animals, Xenopsylla cheopsis or Cortophylus fasciatus, but in exceptional circumstances, it can live in the human flea Pulex irritans, and can even 'hibernate' for up to 6 months in favourable conditions like dung-piles or cargo bales.

Symptoms and treatment

The disease becomes evident 2-6 days after infection. Initial symptoms are chills, fever, headaches, and the formation of buboes. The buboes are formed by the infection of the lymph nodes, which swell and become prominent. If unchecked, the bacteria infect the bloodstream (septicemic plague) and then the lungs (pneumonic plague).

In septicemic plague there is bleeding into the skin and other organs, which creates black patches on the skin, hence the name Black Death. Mortality in untreated cases is 50-90%, but early treatment with antibiotics is effective (usually streptomycin or gentamycin), reducing the mortality rate to around 15% (USA 1980s).

With pneumonic plague the infected lungs raised the possibility of person-to-person transmission through respiratory droplets. After two to four days of incubation the initial symptoms of headache, weakness, and coughing with hemoptysis are indistinguishable from other respiratory illnesses. Without diagnosis and treatment the infection can be fatal in one to six days, mortality in untreated cases may be as high as 95%. The disease can be effectively treated with antibiotics, however.

As a biological weapon aerosolized pneumonic plague is the only effective plague agent.

Historic outbreaks

A special warning has to be made about early epidemics of the "plague", for example in Greek or Roman history or in the Bible - these are usually not well enough documented to make any definite statement about the nature of the disease; the usage of the name stems from the early modern time, when the plague was the only disease known to cause massively killing epidemics. Acral_gangrene_due_to_plague.jpg

Gangrene Due to Plague
Parts of the fingers will likely be amputated to prevent spread

Many scientists believe that there was an outbreak of bubonic plague in the 6th century, starting in Africa and moving to Constantinople and the rest of the Byzantine Empire.

Most scientists believe that the Black Death in the 14th century was an outbreak of bubonic plague. However, other theories have now been advanced, suggesting that the Black Death may have been an outbreak of some other disease, possibly a hemorrhagic fever similar to Ebola, or anthrax.

The Great Plague of 1665 in London is also generally believed to have been an outbreak of bubonic plague.

After a localised outbreak in Provence in southern France in 1720 -1721, Europe suffered no more such attacks of plague, though the disease remained virulent in other regions, killing upwards of ten million in India in the late nineteenth and early twentieth centuries according to some estimates.

The last rat-borne epidemic in the United States occurred in Los Angeles, California in 1924 -1925. Some local scientists have offered warnings about squirrel-born fleas.[1]

Contemporary cases

The disease still exists in wild animal populations in the Caucasus Mountains in Russia, through much of the Middle East, China, Southwest and Southeast Asia, Southern and Eastern Africa, in North America from the Pacific Coast eastward to the western Great Plains and from British Columbia southward to Mexico, and in South America in two areas - the Andes mountains and Brazil. There is no plague-infected animal population in Europe or Australia.

Globally, the World Health Organization reports 1,000 to 3,000 cases of plague every year.

Danger in California

In 1900, infected rats reached California on a ship from Asia. Soon plague spread from the port of San Francisco to other nearby cities, and to deer mice Peromyscus, and other resistant rodents. While towns in Marin and Sonoma counties largely escaped the outbreaks that affected most temperate regions of California, Y. pestis became firmly entrenched in the Coastal and Sierra Nevada Ranges.

Today, plague is endemic in resistent wild rodent populations throughout the western United States. Preditors or scavengers can get the disease when they eat their prey, and hunters when they handle or skin infected game animals. From time to time the bacteria spreads to more susceptible rodents, like ground squirrels Spermophilus beecheyi. Epizootic outbreaks decimate the squirrel colonies, leaving hoards of infected, hungry fleas around the now empty burrows. Sites like these are especially dangerous to hunters, campers and nearby residents.

Public health workers in endemic areas keep a close watch for die-offs in ground squirrel colonies. They sometimes close campgrounds or regional parks as a preventative measure, and apply insecticides to kill the fleas around the abandoned burrow systems. Rangers at Palisades Park in Santa Monica, California, culled ground squirrels to prevent plague recently. People can't wrap their heads around the fact that cute squirrels are deadly disease vectors.

Yersinia pestis

Yersinia pestis is a species of bacterium in the family Enterobacteriaceae, genus Yersinia; it is the infectious agent of bubonic plague. It was discovered simultaneously by Shibasaburo Kitasato and Alexandre Yersin in 1894.

The bacillus was originally called Pasteurella pestis, and was renamed after Alexandre Yersin.

Bacteria are one-celled microorganisms. They have a cell wall which gives it shape (some are also enclosed by a capsule), a cell membrane just inside the cell wall which encloses the cytoplasm and DNA which forms the area of the cytoplasm called the nucleoid.

Bacteria are divided into groups according to their shape: round bacteria are cocci, rod-shaped are bacilli, (bent rods are vibrios) and spiral-shaped bacteria are spirilla or spirochetes. Two or more bacteria linked together are described by prefixes diplo-(pair), staphylo-(cluster), or strepto-(chain).

Bacteria are mostly parasites, only a few manufacture their own food. Some of these parasites are very helpful — they aid in many bodily functions including digestion, and help with other processes, such as decomposition of soil and changing of milk into cheese. Disease results, however, when bacteria multiply rapidly (each cell simply divides into two identical cells) and damage or kill the human tissue, as in pneumonia and tuberculosis.

Diseases can also produce toxins that damage or kill human tissue as in food poisoning or cholera. Sometimes bacteria in the body are helpful for awhile, and then something in the body or the bacteria changes, casing destruction in the host. Segments of DNA in the bacteria can be exchanged with other bacteria when a cell divides in a process called conjugation. This interchange of DNA segments often results in disease. This makes tracking and identification of a disease more difficult.