Recently, a Chinese city in the country’s Inner Mongolia region reported its first suspected case of bubonic plague or ‘Black Death’ on Saturday.

But, before we go any further into this topic, lets go back in history and try to understand what bubonic plague is, how it came into existence, what were its devastating affects and how it all ended.

What is Bubonic Plague?

Bubonic Plague is the most common type of plagues that is caused by a bacteria. It spreads through bacterias that reside on the rodents and it mainly affects the lymphatic system – a part of the immune system by causing inflammation in the lymph nodes.

Is this plague deadly?

Yes, this infection can be deadly and can spread to other parts of the body if not treated with appropriate antibiotics.

When did it all start?

In the mid-1300s, ‘Black Death’ a devastating global epidemic of bubonic plague struck Europe and Asia. The plague made its way into Europe in October 1347, when 12 ships from the Black Sea docked at the Sicilian port of Messina.

Most sailors aboard the ships were dead and those who were alive were terminally-ill and covered in black boils that oozed blood and pus. After seeing this horrifying sight, Sicilian authorities ordered the fleet of ‘death ships’ to be taken out of the habor, but it was already too late. Over the next years, the bubonic plague aka Black Death killed more than 20 million people in Europe, which is almost one-third of the continent’s population.

However, even before the ‘death ships’ arived into Messina, many Europeans had heard stories about a ‘Great Pestilence’ that was forming a deadly path across the trade routes of the Near and Far East. By the early 1340s, the disease had already struck China, India, Persia, Syria and Egypt.

It is believed that the plague originated in Asia over 2,000 years ago and was spread to other parts of the world by trading ships. Though, recent research study claims that the pathogen responsible for the Black Death may have existed in Europe as early as 3,000 BC.

What are the symptoms of bubonic plague?

The infected person generally experiences flu-like symptoms for 2-3 days after getting infected. The symptoms include:
– Sudden onset of fever
– Chills
– Headaches
– Muscle aches 
– Fatigue 
– Seizures

Some individuals also develop painful swollen lymph glands, called buboes – which are about the size of a chicken egg and situated in the armpit, groin, or neck. Perhaps, the buboes are what give the disease – bubonic plague – its name.

Describing the horror of the bubonic plague, Italian poet Giovanni Boccaccio wrote:

…at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.

How did it spread?

The plague spread through contact with infected fleas. Usually, a person would get infected when an infected rodent or flea would bite. However, one could also get infected after coming in contact with an infected animal or person. Even eating an infected animal could get you infected.

Explaining the seriousness of the plague, Boccaccio once wrote:

The Black Death was terrifyingly, indiscriminately contagious. The disease was also terrifyingly efficient. People who were perfectly healthy when they went to bed at night could be dead by morning. 

How is the bubonic plague treated?

The only way to treat bubonic plague is through strong and effective antibiotics. If a person is infected with the plague, he or she is required to be admitted to a hospital for treatment. Bubonic plague, if caught and treated early, is a treatable disease. But, if no treatment is provided on time, the infection can multiply in the bloodstream or in the lungs, which can result in death within 24 hours after the appearance of the first symptoms. 

How was Black Death treated in those times?

Earlier, doctors relied on crude methods like bloodletting, boil-lancing (practices that were dangerous as well as unsanitary) and superstitious practices such as burning aromatic herbs and bathing in rosewater or vinegar.

It was utter chaos back then. While healthy people tried to avoid getting infected, doctors refused to see and treat patients over fears of contracting the disease. Even priests refused to administer last rites of those who died of the plague. Many people also abandoned their sick, dying loved ones in order to secure their own immunity. 

Why did bubonic plague doctors wear strange beaked masks?

Long before the invention of PPE kits, doctors treating patients with bubonic plague wore strange beaked masks that was intended to protect the doctor from ‘miasma’, also commonly called ‘bad air.’

Black Plague: God’s Punishment?

Since many did not understand the biology of the disease, people believed that the Black Death was a kind of divine punishment. People started to believe that God was punishing them for all the sins that they had committed in their lifetime. And by this logic, the only way to overcome to the plague was to win God’s forgiveness and some people thought the way to gain God’s forgiveness was by killing communities of heretics and other troublemakers. Between 1348 and 1349, thousands of Jews were massacred because of this belief. 


So, how did the plague end?

The plague never ended. It returned back again, years later but, officials in the Venetian-controlled port city of Ragusa were able to slow its spread by keeping arriving sailors in isolation until it was clear they were not carrying the disease. They also made social distancing mandatory and sailors were asked to quarantine on their ships for a period of 30-40 days to make sure no other person gets infected. 

What are the preventive measures for bubonic plague?

While there are no vaccines available, one can reduce the risk of being exposed to the plague. 

– One must take steps to reduce rodent habitat around your home, work place, and recreational areas.
– One must ensure that your home and outbuildings are rodent-proof.
–  Keep your pets free of fleas. 
– Wear gloves when handling potentially infected animals to prevent contact between your skin and the plague bacteria. 
– Use insect repellent if you suspect you’re at risk of being exposed to fleas

Does the Black Plague still exist?

The Black Death epidemic ran its course by the early 1350s however, it reappeared after every few generations, for centuries. Though, modern sanitation and public-health practices have greatly helped in reducing the impact of the disease sadly, it has still not been eliminated fully. 

While antibiotics are available to treat Black Death, according to WHO, there are still 1,000 to 3,000 cases of plague reported every year.

For more information, watch this video.