People usually get plague through the bite of fleas that have previously fed on infected animals like mice, rats, rabbits, squirrels, chipmunks, and prairie dogs. It can also be spread through direct contact with an infected person or animal or by eating an infected animal. Plague can also spread through scratches or bites of infected domestic cats.
People infected with the plague usually develop flu-like symptoms two to six days after infection. There are other symptoms that can help distinguish the three forms of the plague. You may also experience painful, swollen lymph glands, called buboes. These typically appear in the groin, armpits, neck, or site of the insect bite or scratch. The buboes are what give bubonic plague its name. Septicemic plague symptoms usually start within two to seven days after exposure, but septicemic plague can lead to death before symptoms even appear.
Symptoms can include:. Pneumonic plague symptoms may appear as quickly as one day after exposure to the bacteria. These symptoms include:. Plague is a life-threatening disease. If you have been exposed to rodents or fleas, or if you have visited a region where plague is known to occur, and you develop symptoms of plague, contact your doctor immediately:.
When you visit the doctor, emergency room, or anywhere else where others are present, wear a surgical mask to prevent the spread of the disease. If your doctor suspects you may have plague, they will check for the presence of the bacteria in your body:.
The samples will be sent to a laboratory for analysis. Preliminary results may be ready in just two hours, but confirmatory testing takes 24 to 48 hours.
Often, if the plague is suspected, your doctor will begin treatment with antibiotics before the diagnosis is confirmed. This is because the plague progresses rapidly, and being treated early can make a big difference in your recovery.
The plague is a life-threatening condition that requires urgent care. With no treatment, bubonic plague can multiply in the bloodstream causing septicemic plague or in the lungs causing pneumonic plague. Death can occur within 24 hours after the appearance of the first symptom. Treatment usually involves strong and effective antibiotics such as gentamicin or ciprofloxacin, intravenous fluids, oxygen, and, sometimes, breathing support.
Medical personnel and caregivers must take strict precautions to avoid getting or spreading plague. Plague can lead to gangrene if blood vessels in your fingers and toes disrupt blood flow and cause death to tissue.
In rare cases, plague can cause meningitis, an inflammation of membranes that surround your spinal cord and brain. Keeping the rodent population under control in your home, workplace, and recreation areas can greatly reduce your risk of getting the bacteria that causes plague. Keep your home free from stacks of cluttered firewood or piles of rock, brush, or other debris that could attract rodents.
Protect your pets from fleas using flea control products. Pets that roam freely outdoors may be more likely to come into contact with plague-infected fleas or animals. If the disease spread to the lung through the blood, it caused an invariably fatal pneumonia, pneumonic plague, and in that form plague was directly transmissible from person to person. The three great plague pandemics had different geographic origins and paths of spread.
The third pandemic, that of , originated in Yunnan, China, and spread to Hong Kong and India, then to the rest of the world. The causative organism, Yersinia pestis , was not discovered until the pandemic and was discovered in Hong Kong by a French Pastorien bacteriologist, Alexandre Yersin. Four years later in his successor, Paul-Louis Simond, a fellow Asia and migrated westward on the sea routes from China and India. The brown rat flourished in Europe where there were open sewers and ample breeding grounds and food and in the 18th and 19th centuries replaced the black rat as the main disease host.
The primary vectors for transmission of the disease from rats to humans were the Oriental or Indian rat flea, Xenopsylla cheopis , and the Northern or European rat flea, Nosopsyllus fasciatus.
The human flea, Pulex irritans , and the dog and cat fleas, Ctenocephalides canis and felis, were secondary vectors. In the pandemics, the infected fleas were able to spread the plague over long distances as they were carried by rats and by humans travelling along trade routes at sea and overland, and also by infesting rice and wheat grain, clothing, and trade merchandise. When infected, the proventriculus of the flea becomes blocked by a mass of bacteria. The flea continues to feed, biting with increasing frequency and agitation, and in an attempt to relieve the obstruction the flea regurgitates the accumulated blood together with a mass of Yersinia pestis bacilli directly into the bloodstream of the host.
The fleas multiply prolifically on their host and when the host dies they leave immediately, infesting new hosts and thus creating the foundations for an epidemic. The first great pandemic of bubonic plague where people were recorded as suffering from the characteristic buboes and septicaemia was the Justinian Plague of CE, named after Justinian I, the Roman emperor of the Byzantine Empire at the time. The epidemic originated in Ethiopia in Africa and spread to Pelusium in Egypt in It then spread west to Alexandria and east to Gaza, Jerusalem and Antioch, then was carried on ships on the sea trading routes to both sides of the Mediterranean, arriving in Constantinople now Istanbul in the autumn of Procopius wrote of the symptoms of the disease :.
And the body showed no change from its previous colour, nor was it hot as might be expected when attacked by a fever, nor indeed did any inflammation set in, but the fever was of such a languid sort from its commencement and up till evening that neither to the sick themselves nor to a physician who touched them would it afford any suspicion of danger.
It was natural, therefore, that not one of those who had contracted the disease expected to die from it. Over the next three years plague raged through Italy, southern France, the Rhine valley and Iberia.
Between the years and epidemics in Asia, Africa and Europe killed nearly million people. The pandemic had a drastic effect and permanently changed the social fabric of the Western world. Food production was severely disrupted and an eight year famine followed. The agrarian system of the empire was restructured to eventually become the three field feudal system. The social and economic disruption caused by the pandemic marked the end of Roman rule and led to the birth of culturally distinctive societal groups that later formed the nations of medieval Europe.
Further major outbreaks occurred throughout Europe and the Middle East over the next years — in Constantinople in the years , , and , in Iraq, Egypt and Syria in the years , , , , and and Mesopotamia in and The plague continued in intermittent cycles in Europe into the mid-8th century and did not re-emerge as a major epidemic until the 14th century. The Black Death of was the first major European outbreak of the second great plague pandemic that occurred over the 14th to 18th centuries.
In it was known in the European seaports that a plague epidemic was present in the East. In the plague was brought to the Crimea from Asia Minor by the Tartar armies of Khan Janibeg, who had laid siege to the town of Kaffa now Feodosya in Ukraine , a Genoese trading town on the shores of the Black Sea.
The siege of the Tartars was unsuccessful and before they left, from a description by Gabriel de Mussis from Piacenza, in revenge they catapulted over the walls of Kaffa corpses of people who had died from the Black Death.
The Tartars left Kaffa and carried the plague away with them spreading it further to Russia and India. A description of symptoms of the plague was given by Giovanni Boccaccio in in his book Decameron, a set of tales of a group of Florentines who secluded themselves in the country to escape the plague :.
Some of which grew as large as a common apple, others as an egg, some more, some less, which the common folk called gavocciolo. From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently; after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere,..
Butler [11] states the term refers to the haemorrhagic purpura and ischaemic gangrene of the limbs that sometimes ensued from the septicaemia. People were as much afraid they would suffer a spiritual death as they were a physical death since there were no clergy to perform burial rites:. The sexton and the physician were cast into the same deep and wide grave; the testator and his heirs and executors were hurled from the same cart into the same hole together.
Transmission of the disease was thought to be by miasmas, disease carrying vapours emanating from corpses and putrescent matter or from the breath of an infected or sick person. Others thought the Black Death was punishment from God for their sins and immoral behaviour, or was due to astrological and natural phenomena such as earthquakes, comets, and conjunctions of the planets.
People turned to patron saints such as St Roch and St Sebastian or to the Virgin Mary, or joined processions of flagellants whipping themselves with nail embedded scourges and incanting hymns and prayers as they passed from town to town. As they always marched two abreast, the procession of the numerous penitents reached farther than the eye could see.
Soon there was a shortage of doctors which led to a proliferation of quacks selling useless cures and amulets and other adornments that claimed to offer magical protection. In this second pandemic, plague again caused great social and economic upheaval. Often whole families were wiped out and villages abandoned. Crops could not be harvested, travelling and trade became curtailed, and food and manufactured goods became short. The villeins prospered and acquired land and property. The plague broke down the normal divisions between the upper and lower classes and led to the emergence of a new middle class.
In the period to the Black Death killed a quarter of the population in Europe, over 25 million people, and another 25 million in Asia and Africa.
In when another epidemic of the Black Death re-emerged in Europe, Venice instituted various public health controls such as isolating victims from healthy people and preventing ships with disease from landing at port. The trentena was found to be too short and in in Venice, travellers from the Levant in the eastern Mediterranean were isolated in a hospital for forty days, the quarantena or quaranta giorni , from which we derive the term quarantine. Bubonic plague: Patients develop sudden onset of fever, headache, chills, and weakness and one or more swollen, tender and painful lymph nodes called buboes.
This form usually results from the bite of an infected flea. The bacteria multiply in the lymph node closest to where the bacteria entered the human body. If the patient is not treated with the appropriate antibiotics, the bacteria can spread to other parts of the body. Septicemic plague: Patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs.
Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. Septicemic plague can occur as the first symptom of plague, or may develop from untreated bubonic plague. This form results from bites of infected fleas or from handling an infected animal. Pneumonic plague: Patients develop fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous.
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