What does Bubonic plague mean?
Bubonic plague was the most common type of pandemic during the bacterial plague pandemics. The name originated due to typical black sores appeared on whole body due to internal haemorrhages known as “buboes” Symptoms of bubonic plague were severe swelling in the groin and armpits (the lymph nodes), raging fever and joint pains.
There are few pandemics due to bacterial diseases in the course of history which ravaged human population throughout human civilization. Here are few deadly outbreaks which left marks on human history and development of modern day health care system before the discovery of bacteria and antibiotics.
Antonine Plague (165 AD)
Antonine plague (Bubonic plague) during 165-180 AD spread throughout the Roman Empire and other areas like Asia Minor, Egypt, Greece, and Italy. The total death due to plague has been estimated nearly five to ten10 million which was almost 10% of the Roman Empire population. Ancient Roman plague is also known as “the Plague of Galen” after Galen, the Greek physician who described it. It was the first known pandemic erupted in whole Roman Empire during the last years of Co-emperor Marcus Aurelius reign which was considered the “golden age” of Rome
Plague of Justinian (541-542 CE)
Justinian Plague is the popular name of bubonic plaque pandemic erupted in late Roman or Byzantine empire in probably 541 CE and waves of pandemic re-erupted for next 200 years in different geographical regions until 750 CE. The Plague of Justinian, during its year long reign of killed more than 25 million people. Almost half the population of Europe, up to a quarter of the population of the Eastern Mediterranean and it almost devastated Constantinople whose 40 % population died with of mortality rate of 5,000 people per day.
In 2013, researchers confirmed after DNA analysis of bones found in graves, that the cause of pandemic was Yersinia pestis. Transmission of plague was the black rat (Rattus rattus), which travelled on the grain ships and carts sent to Constantinople as tribute. Primary source of grain for the empire was North Africa and grains provided a perfect breeding ground to fleas and rats which were crucial to the transmission of plague across continents.
Procopius, in his Secret History, explained the symptoms of disease as fever and swelling in groin armpits, and behind their ears, suffering from delusions and nightmares. He wrote that patients lapsed into comas while others became highly delusional. Many suffered for days before death due to symptoms while several died immediately after the onset of symptoms. He also blamed the Byzantine Emperor Justinian for outbreak and declared him a devil and claimed that the emperor was cursed and punished by God for his evil ways.
The Black Death (1346-1353)
In 1347 bubonic plague pandemic erupted in Europe, caused huge devastation and highest number of death toll (75 – 200 million) than any other epidemic or war up to that time. Black Death was originated in central Asia and spread to the Crimea by Mongol warriors and traders. It further spread to Europe through route of Genoese trading ships sailing from the Black Sea via Italy.
The disease was carried by fleas living on rats or human parasites carried on trading ships. At that time, ports were the major urban center’s and provided perfect breeding ground for the rats and fleas carrying disease causing bacterium devastating three continents in its wake. In 1400, the population in England was half that the population of Europe 100 years earlier the pandemic caused depopulation or total disappearance of about 1,000 villages. If untreated, it was fatal up to 30-75% and
There are 3 types of plague including
- Bubonic plague
- Pneumonic plague and
- Septicaemia plague.
All of them were present in the Black Death pandemic although bubonic plague was common while pneumonic (or pulmonary) and septicemic were fatal in all cases.
There was no treatment of the disease and there was no idea of microscopic organism causing disease therefore avoiding people and praying was the only solution. The pandemic ended by 1352 but recurred again in less severe outbreaks throughout next medieval period. The death toll was so high that that the authorities did not know what to do with the corpses and the carts piled high with dead bodies became a common sight throughout Europe.
The 17th Century Great Plagues
During 17th century, plagues erupted endemically causing three million deaths. Before the starting of this era period plagues were already endemic in Constantinople and along the Danube.
In 1703, plague erupted in Ukraine and in 1704 it started to spread in Poland, Silesia, Lithuania Prussia, and large geographical area of Germany and Scandinavia. In Prussia and Lithuania 283,000 people died.
In 1710, plague erupted in Copenhagen killing 40,000 people. Meanwhile, it also spread from the Danube to Transylvania and Styria. In 1713 it became endemic in Austria and Bohemia, causing high mortality in Vienna. Haeser states that the plague disappeared in Europe after the great hurricane of February 27, 1714.
In 1717 plague caused huge devastation in Constantinople and re-emerged in 1719 and spread in Transylvania, Hungary, Galicia, and Poland. Plague outbreak appeared in southern France in 1720-22. In December 1721 the plague disappeared although isolated cases occurred in 1722.
In 1743, an outbreak of plague erupted at Messina, Sicily. Messina prided themselves on strict compliance of the quarantine laws which saved them and they made silicy free from plague since 1624. However, in May 1743 a vessel arrived from Corfu which reported some suspicious deaths. Although they burnt the cargo but soon after suspicious cases were reported in hospitals and poor parts of town leading to epidemic causing 40,000- 50,000 deaths and then the outbreak vanished extinct without spreading further to the other parts of Sicily.
THIRD CHOLERA PANDEMIC (1852–1860)
There were seven cholera pandemics however; the third cholera is generally considered the most fatal outbreak of Cholera which erupted in 19th (1852 to 1860). Almost 1 million people died in third cholera pandemic. All of the first, second and third cholera pandemics originated from India spreading from the Ganges River Delta to Asia, Europe, North America and Africa causing deaths of million people. In 1854, almost 23,000 people died in Great Britain due to the illness.
John Snow, a British physician, in 1854 tracked cases of cholera in London and successfully identified that the contaminated water as the means of cholera transmission. He identified that the contaminated food and water were the cause of disease. It was identified that the source of contamination was faeces of patient that contaminate water or food. Therefore, it was supposed that the disease may spread in the areas with inadequate treatment of sewage through drinking water.
The deadly pandemic was caused by infection of intestine by bacteria Vibrio cholera. In cholera pandemic patient suffered from an acute diarrheal illness or profuse watery diarrhoea also called as “rice-water stools” vomiting, dehydration, thirst, leg cramps. The symptoms were mild to severe or life threatening.
SIXTH CHOLERA PANDEMIC (1910-1911)
The Sixth Cholera pandemic like previous five pandemics also originated from India killing more than 800,000 people and further spread to the Middle East, North Africa, Eastern Europe and Russia.
Sixth cholera pandemic was the cause of seventh outbreak of cholera erupted in America in 1910–1911. American health authorities controlled the outbreak by strict quarantine measures as learned from the past and isolated the infected patients and dramatically decreased the cases as by 1923 only 11 cases reported in America however it was still erupting in India.
