What a Pest

Why the Black Death still won't die.

BY EMILY ANTHES | NOVEMBER/DECEMBER 2009

For a microscopic organism, Yersinia pestis has made an outsize mark on human history. It has felled some 200 million human beings since it first evolved, in addition to provoking political, economic, social, and cultural upheavals. This toll of death and devastation has earned the disease resulting from this bacterium the right to be called, simply, "The Plague." And though it certainly has a long history, this tiny killer also has a bright future.

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Plague has never really disappeared, but it suddenly seems poised for a comeback. Indeed, world health officials have quietly recategorized plague as a "re-emerging" disease in recent years, and it now infects 2,000 people annually, killing 200. The Chinese government even quarantined an entire town this summer after an outbreak of pneumonic plague, which eventually killed three and infected nine more. And experts fear the next stage of the disease will be especially dangerous, fueled by age-old phenomena, such as humans trying to use plague to wage war on their enemies, as well as new ones, such as climate change.

Welcome to the plague years, the next generation. For most people, plague automatically means the Black Death, which began in the 14th century and killed a quarter to a third of Europe's population, roughly 15 million to 25 million people. This is the best-known plague pandemic, but it wasn't the first. That honor goes to a sixth-century outbreak that originated in northern Africa and took out as many as 100 million people. Nor was the Black Death the last major pandemic. Plague spread through China and India during the 19th century, killing some 12 million people, and then spread to the United States in 1900, causing an epidemic in San Francisco.

Between major pandemics, the plague never completely disappeared. It never does: It merely retreats until conditions favor another outbreak. Plague "would be virtually impossible to eradicate," says Ken Gage, chief of the flea-borne diseases branch of the U.S. Centers for Disease Control and Prevention. "The reservoir is rodents, and it's very widespread." Indeed, Y. pestis is endemic in many populations of rats, mice, squirrels, marmots, gerbils, and other rodents. Fleas that feed on these infected animals can pass the disease along to humans. The unlucky recipients usually come down with flu-like symptoms, and death is often a torturous ordeal. All three forms of the disease -- bubonic plague, pneumonic plague, and septicemic plague -- can be easily cured with antibiotics, assuming it's caught early. When it isn't, the prognosis is poor, with a mortality rate of 50 to 100 percent.

Today, plague is endemic among the rodents of the American Southwest. Isolated outbreaks also occur regularly in East and Southern Africa, Vietnam, Burma, China, Mongolia, Russia, and Central Asia. What's more, there are already troubling signs that the disease is evolving into even more dangerous forms: Scientists recently discovered a drug-resistant strain of the plague in Madagascar.

 

Emily Anthes is a science writer in Brooklyn, N.Y.

GRANT

11:08 AM ET

October 19, 2009

Terrorists and nations are

Terrorists and nations are probably a low level threat for the spread of plague though climate and rodents are considerably more difficult to deal with. Historically speaking actors are reluctant to use such weapons on each other partially out of moral concerns and partially because they are understandably afraid of having the same tactics used on them. Of course terrorists change this equation, but that assumes that terrorists would use these tactics after the abysmal failure of Aum Shinrikyo and that some government would trust a terrorist group with such an uncontrollable weapon.

 

BILL G

4:57 PM ET

October 19, 2009

Black Death may not have been Bubonic Plague

Good article. I'm posting only to note that there's fairly compelling evidence to suggest that the Black Death was not Bubonic Plague, but some kind of a virus that is transmitted by droplets. This is why the 40 day quarentine was invented. About all we can tell from this remove was that the virus caused a lethal hemorrhagic fever.

Of course Bubonic Plague is a heck of a danger in its own right. So your article is sound in its warning.

Bill