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Ebola: the new Black Death?

by S D Sykes, author of PLAGUE LAND

In October 1347 a fleet of Genoese ships sailed into the Italian port of Messina. Their freight contained not just the goods they were transporting from the trading city of Caffa in the Crimea, but also a deadly cargo: the Plague. Here is a contemporary account of what happened next.

‘When the inhabitants of Messina discovered that this sudden death emanated from the Genoese ships, they hurriedly ordered them out of the harbour and town. But the evil remained and caused a fearful outbreak of death. Soon men hated each other so much that if a son was attacked by the disease his father would not tend to him.’

Sounds familiar, doesn’t it? One needs only to pick up a newspaper or surf the internet to see the fear and panic that Ebola is generating. Contagion, death and hysteria are a potent mix.

But is Ebola anything like the Black Death? Will the virus sweep across Europe as did the Plague 650 years ago, killing vast swathes of humanity whilst causing terror, suffering and devastation? Indeed, should we all be fleeing to the hills, stocking up on tinned food and buying a gun? Is it, as the World Health Organisation has just announced, a threat to whole societies?

To examine this further, I’ve done (in true school-essay style) a quick compare and contrast, beginning with the differences between the two diseases. The first distinction is the most fundamental. Ebola is a virus, whereas as the Black Death is bacterial infection caused by the bacillus Yersina Pestis. Both are deadly and contagious, but kill in a different way.

So, if you were infected during the Black Death, the bacillus might have entered your body via the bite of an infected flea. This bacillus then localized in your lymph glands where it rapidly multiplied by cell division, causing hemorrhaging and swelling. These swellings in the groin and armpits soon became black, due to the necrotizing of the flesh, and were known as buboes – hence the Bubonic Plague. But worse, and far more contagious than the Bubonic Plague, was the Pneumonic Plague, caused when the same bacillus infected the victim’s lungs, and was spread, person to person, by airborne droplets (i.e coughing). Research is now indicating that it was the Pneumonic, rather than Bubonic, Plague that caused the rapid onset and incredibly high mortality rate of the Black Death.

Ebola, by contrast, is contracted when you touch and subsequently ingest the virus from the bodily fluids (such as vomit and blood) of an existing victim. The virus then invades the host cells in your internal organs, where it uses the structure of your cells to multiply, causing you to bleed to death internally.

Neither is a pleasant way to die. But we do, at least, know exactly what Ebola is. We have seen its devilish strands swimming about under a microscope.

By contrast, the people of the 14th century had no idea what had caused the Plague – the bacillus Yersinia Pestis was not identified until 1894 – and instead blamed the Plague on punishment from God; the poisoning of wells by the Jews; bad planetary alignment; even the fashion for wearing lewdly tight hose and revealing tunics. Nothing ‘just happened’ in the middle ages. There was always a meaning to such an event, no matter how misconstrued.

And then we come onto fear and anticipation… or I should say, justified fear and anticipation. Reading the BBC website over recent weeks, anything to do with Ebola is often the ‘most shared’, or the ‘most read’ story, even though – and let’s be frank about this – the average British person is not going die from, let alone catch, this virus. Ebola is becoming a sort of modern day bogey-man. A fantastic way to scare ourselves stupid. If we’re so terrified of an untimely death perhaps we ought to take more care crossing the road, or stop smoking and be more active? The Black Death, however, caused fearful anticipation with total justification. It spread through Europe like a flood, and killed between a third and half of the population. It was rightly seen as apocalyptic. People knew exactly what was coming and what it would do to them.

So what are the similarities between the two diseases? Firstly, both can trace their beginnings back to a connection between man and beast. With the Black Death it was rats, or more specifically rat fleas. In the case of Ebola, the virus exists in the fruit bat population, but has moved into the human population probably via the consumption of bush meat.

Secondly we come onto the role of superstition and ignorance, and how these two factors make the task of constraining an infectious disease even more difficult. This was definitely the case in the 14th century, when the Plague was treated with the most bizarre of remedies, including the smearing of faeces onto the buboes and the drinking of urine. It was also believed that contagion was carried in poisoned odours; the patient was often given a bunch of fragrant herbs to sniff upon, or a cut onion was placed beside their bed to ward off any miasmas. I think we can agree that this was entirely pointless! If the herbs and onions weren’t for you, then praying for deliverance was pretty much the only other option – as indeed was making pilgrimages to holy sites. But this can only have exasperated the problem of infection, as gathering in a church to pray or making a communal pilgrimage provided the perfect opportunity for spreading the disease.

Sadly, superstition and ignorance has had its part to play in Africa, as beliefs in some remote villages are hampering efforts to stop the spread of the Ebola virus. Many sufferers are reluctant to seek medical attention, believing instead that Ebola is the work of sorcerers and can only be treated by witchcraft. Western medical workers and their protective clothing are often seen as threatening, even evil – recently a group of aid workers was murdered in a remote village in Guinea, an example of how suspicion and mistrust is fuelling the crisis. To compound the problem further, funeral customs in this part of Africa often include touching and kissing the bodies of the dead, inevitably leading to further infection. And for those who survive Ebola, sometimes the outcome is little better, as they are often shunned by their communities, who believe they are still infectious.

So could Ebola be the next Black Death? In a word, no. I know dire warnings are published in newspapers or broadcast on television and radio at every news bulletin. I know cases have turned up in the USA and Spain, and I know a nurse caught it from her protective clothing, but it is actually rather difficult to spread Ebola. Crucially, the virus is not airborne, so a single sufferer is not able to exponentially infect others, as was the case with the Pneumonic Plague during the Black Death years. Should the Ebola virus makes a mass break-out from Africa, we will have the infrastructure and medical expertise to deal with it. We will see cases in the UK, of that I am in no doubt. But they will be in low numbers and they will be quickly dealt with.

So perhaps we need to stop panicking about how Ebola might affect us and concentrate on helping those who are actually at risk? I think so.

S D Sykes’ debut historical crime novel, PLAGUE LAND is out now, available in hardcover and as an eBook from Hodder & Stoughton. To find out more about S D Sykes and her writing, visit Sarah’s website and follow her on Twitter