The Bubonic Apocalypse: a possible resurgence of the Black Death

Science and Gaming Editor, Clara Cohen, discusses whether we could see a repeat of the bubonic plague in the 21st century.

The Black Death, or bubonic plague, is one of the most infamous epidemics of the western world. The disease spread across most of Europe, killing between 75 and 250 million people in the space of 7 years. The plague was caused by Yersinia Pestis, a bacterium of the enterobacteriaceae family which could kill an infected human in 3 to 7 days. This particular strain of bacterium has reappeared multiple times since the 14th century, but could we expect to see a full resurgence of the bubonic plague in our modern times?

The bubonic plague was an illness that ravaged most of Eurasia. It first presented with buboes, blackened and swollen lymph nodes around the armpits and groin which often leaked pus and would bleed when pierced. After that came a high fever and hematemesis, or the vomiting of blood. If the victim did not pull through in the first couple of days, then the disease would ultimately lead to death. Though the antiquated ideas of the dark ages suggest the pandemic was caused by the wrath of God, the illness was actually cause by Yersinia Pestis. Y. Pestis or, as it used to be known, Pasteurella Pestis, was identified by a French Physician named Alexandre Yersin in 1894.

It works by supressing immune symptom responses in macrophages and other immune cells. The infection can rapidly spread through different internal organs, though it focuses on the lymphatic system, resulting in the recognisable buboes. Although the Black Death seemed to disappear entirely in 1670, outbreaks of the plague still appear to this day.

In today’s world, the disease is most commonly found throughout America, Africa and Asia. In 1995, there was an outbreak of the bubonic plague in Majunga, Madagascar. Majunga is a port city, to the North of the island. The scientists who studied the plague cases feared that the maritime movement to and from the city would increase the spread of the epidemic. In the 14th Century, plague fleas were carried by rats, which were transported across the channel from Europe by boats. These vessels became known as Plague Ships. Although outbreaks in port cities were never sustained for too long, unless the rats and fleas could find a suitable habitat, the disease was fatal to many inhabitants of Majunga.

Of the 394 tested individuals, 15.2% were confirmed to have the plague and, after 9 months, 24 victims had died. Over the course of the 20th Century, 805 individuals had probable or confirmed cases of the bubonic plague in the United States of America. A study showed that the plague was found to be present for one or more years in 14 out of 25 countries in Latin America. Although the modern day outbreaks have avoided Europe, the effects of climate change and globalization could risk the safety of the European population.

The Black Death, or bubonic plague, stopped being a major threat over 400 years ago, but it is still active around the world and still poses a risk to our health, with over 3000 cases reported annually to the World Health Organisation.

New strains of Y. Pestis which possess a high-level resistance to antimicrobial agents have been discovered in the past 20 years. These strains are not isolated incidents, but potentially the emergence of a new global threat to public health.

A second Black Death that sweeps the earth is a very real possibility in this age of high-speed transport, and if we can’t find a new treatment for the resistant strains, we might not be able to avoid it.