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Could the Black Death happen again? – by S D Sykes

Posted on: 30/01/2014 with tags: Black Death, contagion, death, debut novel, disease, England, historical fiction, history, Madagaskar, plague, plague land, s d sykes

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An article concerned with the Bubonic Plague in this week’s online Lancet has led others to ask – could the Black Death grip the world in another deadly pandemic – as it has done on three previous occasions? In other words should we start panicking? Stocking up on bottled water and tinned beans? Building underground shelters, armed fortresses and mass graves?

The Black Death is such an emotive term, conjuring up death-by-boils, greasy black rats and peculiar men posing as doctors in sinister beak-shaped masks. But what actually is it – this deadly and contagious killer? For a start it’s bacterium, not a virus. The disease is caused by the bacillus, Yersinia Pestis which lives in the digestive tract of infected fleas and has two main forms – Bubonic and Pneumonic.

So, imagine it’s the summer of 1350 and you’ve just been bitten by an infected flea. A flea that was living in some clothes you decided to re-home from a dead relative; or perhaps more likely a bite from a flea that was living on one of the many rats you share your life with. The disease most likely to kill you now is the bubonic form of the plague, which is an infection of the lymphatic system. To begin with you will suffer a high temperature, sweating and severe aches to the joints. So, not unlike the flu. After a day or so however, you’ll develop painful swellings in the lymph nodes of your armpits and groin – and as these painful lumps (buboes) grow to the size of an egg and then turn from red to black due to internal bleeding, your body will become overwhelmed by a bacterial infection. You will almost certainly, but not absolutely definitely, die.

But let’s say it’s the winter of 1350 and with the fleas not so active in the colder temperatures, you feel lucky to have survived the plague so far. Not so lucky is your husband, who is suddenly running a high fever and coughing up blood. He is actually suffering from the pneumonic form of the disease, as the same bacillus Yersinia Pestis, has infected his respiratory system rather than his lymphatic. Now you don’t catch the plague by being bitten by an infected flea, instead you catch it by the airborne transmission of infected droplets i.e by getting too close to your patient. And if a coughing husband doesn’t kill you, then you could always inhale the faeces of the many infected fleas that are now over-wintering inside your home. However you infect yourself with the pneumonic plague, this virulent and highly contagious form of the disease will be rapid in its onset and will always be fatal.

So that’s what the plague is. But could we experience it again? In my opinion, it’s very unlikely – so perhaps you can forget about tinned beans and moving to an isolated fortress. For a start the plague is treatable with antibiotics, if caught early enough in the infection. Of course there’s always the possibility that the bacillus Yersinia Pestis will mutate, and we all know about the increasing resistance of bacteria to drugs – but I’m still not convinced about the re-emergence of a pandemic that relies mainly upon a host reservoir of rodents. Why?

We just don’t live the way we did in the middle ages. We don’t fling our excrement into the streets. We don’t live cheek by jowl with farm animals and then turn a blind eye to rats running about all over our houses. If we experienced a strange flea bite, we’d go to the doctors. The same with coughing up blood.

In short we have drugs, sanitation and knowledge.

So spare a thought for the population of Madagascar, who have little of these three vital factors in fighting the disease. It’s a country where they still suffer between 300 and 600 cases per year (80% of the world’s bubonic plague cases). Where outbreaks, which start in the over-crowded and rat-infested prisons, often threaten to spread to the larger towns. Communities where people live in unsanitary conditions, which have only been worsened by recent political unrest. Where they have little access to antibiotic medication, and where rodents often infest domestic rice stores. If anybody is at risk from another plague, it is these people, as the Black Death is a disease of poverty.

S D Sykes’ debut historical novel, PLAGUE LAND, set in England in the 14th Century, will be published in the autumn by Hodder & Stoughton.

Amy Dolman

Post author: Amy Dolman

Amy is responsible for the smooth running of the H for History website, and enjoys reading history-based fantasy. She also like to photograph sites of historical interest in her spare time with a cup of bovril and a pork pie for company. Favourite period of history: Ancient; Favourite historical read: Everyone Brave is Forgiven by Chris Cleave; Upcoming book i'm most looking forward to: Mister Memory by Marcus Sedgwick

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