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Bubonic plague: a history lesson and case for IPM

In light of yesterday’s Entomology Today post about the outbreak of bubonic plague in Madagascar, I figured it was time for a history lesson. We don’t hear much about the plague anymore, so I wondered, how did it start? How did it spread? And how much has IPM contributed to the scarcity of outbreaks?

Bubonic plague, or the Black Death, as it was called, is infamous in world history. In the 1340s it killed well over 20 million people in Europe and had traveled through the Near and Far East. Symptoms included swollen lymph nodes, or “boboes,” followed by fever, vomiting, diarrhea and black pustules all over the body (which is where the nickname came from). Death came within four or five days.

At that time, and in the 1600s when the plague revisited London, no one knew how to prevent or cure it. Medical knowledge was limited at best, so doctors tried “curing” the disease through leeches and lancing the boils, and many residents tried to prevent getting sick by fleeing to uninfected parts of the country, often leaving their sick family members behind. The children’s rhyme, “Ring around the rosie” began during the plague. The posies in the second stanza refer to the flowers that people carried to breathe into to avoid the stench associated with the disease and possibly to protect themselves from the disease.

The plague arrived in Europe via Genoese trading ships that docked at the Sicilian port of Messina. As they are today (transporting invasive species), ships were refuges for unwanted species. Rats, especially the black rat, were common on ships, and the rat flea, Xenopsylla cheopis, was responsible for transmitting the bacteria that caused the plague, Yersinia pestis.

If anyone ever needs a reason of why rat control in schools is necessary, tell the story of the bubonic plague. In the 1300s it was one of the most feared times in history, because no one knew how the disease had come to Europe and no one had a cure for it. Although today’s antibiotics keep the disease from most developed countries, outbreaks still occur (like yesterday’s outbreak in Madagascar) and make headlines. Now, however, the death toll is minimal compared to the large percentages of populations that were literally wiped out in the middle ages.

Y. pestis can be transmitted either through a rat or flea bite, although other small mammals can transmit the bacteria (but the rat flea is the most common carrier). After and outbreak in China in 1855, scientists in Hong Kong isolated the rod-shaped bacillus in 1894, and later noticed that human victims had flea bites and rats exhibited the same symptoms as humans. It wasn’t until 1990 that the bacterial genomes were studied, through remains exhumed from the 1665 London and 1680 Marseille epidemics, and researchers found that the strain found in the remains closely matched the Y. pestis bacteria.

Today most patients survive if given doses of streptomycin or gentamycin, but if left untreated, victims have at least a 50 percent chance of death (sources differ about this; some indicate it can be up to 65%). Outbreaks typically are isolated to developing countries and originate in places like prisons, where conditions are less than sanitary and rats are common. Visitors to the prisons and released prisoners often unwittingly spread the disease to their villages.

If there ever was a case for IPM, it’s this: if you prevent the rats, you prevent the fleas. If you prevent the fleas, you prevent the disease. One of the primary reasons why we hear so little about bubonic plague outbreaks today is that in most cases, sanitary conditions that exclude rats prevent transmission to start with.


Bubonic plague kills at least 20 in Madagascar. Entomology Today, 11 Dec 2013, http://entomologytoday.org/2013/12/11/bubonic-plague-kills-at-least-20-people-in-madagascar/

Beaumont, Peter (11 Dec 2013). Bubonic plague killed 20 villagers in Madagascar, health experts confirm. The Guardian. Retrieved from http://www.theguardian.com/world/2013/dec/11/bubonic-plague-killed-villagers-madagascar/

The Black Death, 1348. EyeWitnesstoHistory.com, http://www.eyewitnesstohistory.com/pfplague.htm

Black Death. History.com, Retrieved 11 Dec 2013 from http://www.history.com/topics/black-death

Plague. Centers for Disease Control and Prevention. Retrieved 11 Dec 2013 from http://www.cdc.gov/plague/history/.

Berry, Gail. “Ring Around a Rosie”: a brief history of the bubonic plague. Health Decide. Retrieved 11 Dec 2013 from http://healthdecide.orcahealth.com/2012/08/21/ring-around-a-rosie/#.Uqosf2RDt14.

Plague: the Black Death. National Geographic. Retrieved 11 Dec 2013 from http://science.nationalgeographic.com/science/health-and-human-body/human-diseases/plague-article/.

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